Behavior Analysis (BA) Providers Must Have Active National Provider Identifier (NPI)
Date: 03/11/26
The Agency for Health Care Administration (AHCA) will soon require Behavior Analysis (BA) providers to have an active National Provider Identifier (NPI) to submit claims and enroll in Florida Medicaid.
This requirement will take effect on March 27, 2026.
BA providers (Provider Type 39) will need an active NPI to submit claims via the Florida Medicaid Secure Portal starting March 27, 2026. Providers will also need an active NPI to access AHCA’s new provider enrollment system, which will launch this year.
Providers whose NPI is inactive or missing from their provider file will not be able to merge an existing account with a new account. This could delay enrollment and renewals and even result in access to that account being restricted.
Acquiring and maintaining an active NPI is both a federal and state requirement, and providers must have an active NPI as part of the Medicaid enrollment agreement.
Read the AHCA Alert: Provider Type(s): 39 - Behavior Analysis Missing National Provider Identification (NPI) on Provider File Action Needed by 3/26/2026
This Guidance Applies to These Health Plans
- Sunshine Health Medicaid (MMA)
- Children’s Medical Services (CMS) Health Plan
- Sunshine Health Pathway to Shine Child Welfare Specialty Plan (CWSP)
- Sunshine Health Mindful Pathways Serious Mental Illness Specialty Plan (SMI)
- Sunshine Health Power to Thrive HIV/AIDS Specialty Plan (HIV)
NPI Resources
Verify a Provider NPI
- Log into the Florida Medicaid Secure Portal
- Select Demographic Maintenance
- Review the Provider Information panel to confirm if an NPI is present
Obtain a Provider NPI
Visit the National Plan & Provider Enumeration System
NPI Links
- National Provider Identifier Quick Reference Guide: Learn more about Florida Medicaid and the NPI.
- NPI Self Service Tool Quick Reference Guide: Utilize to add or update NPI information.
- NPI to Medicaid ID Search Engine Quick Reference Guide: Utilize to view the Medicaid ID associated with an NPI.
- National Provider Identifier (NPI) Standard: Learn more about the NPI from the Centers for Medicare & Medicaid Services.
Behavior Analysis (BA) Resources
These Sunshine Health resources can help BA providers answer their questions and stay informed:
- BA Provider Quick Reference Guide (QRG): One-stop guide with information about authorizations, billing, claims and other important topics.
- Frequently Asked Questions (FAQ): Find answers to provider questions.
- RBT Credentialing: Sunshine Health streamlined the Registered Behavior Technician (RBT) credentialing requirements.
- AHCA: Florida has more information and resources for BA providers.
Questions?
Sunshine Health has a wealth of resources available to help answer your questions and address your concerns:
- Provider Support: Finding the Right Contact
- Provider Services: Call 1-844-477-8313
- Secure Provider Portal: Visit the Secure Provider Portal to check member eligibility, submit claims and more.
- Provider Engagement: Use the Find Your Account Manager tool to find the Provider Engagement Account Manager (PEAM) supporting your specialty and region.
- Claim Concerns: Resolve outstanding claims using the Claim Concerns form.
- Provider News: Bookmark Provider News to keep up with the latest updates.
- Provider Newsflash: Subscribe to our e-newsletter to get regular updates.
- Provider Resources: Visit Manuals, Forms and Resources to find provider manuals, important forms, scheduling standards and other resources.
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