New CMS Requirement to Enter Your Digital Endpoint Into the NPPES

For years, one of the biggest complaints that providers have had about the Promoting Interoperability program has been that they are unable to obtain direct messaging addresses for their coordinating providers. When I speak with practices, the number one reason I hear for why their Support Electronic Referral Loops by Sending Health Information and Support Electronic Referral Loops by Receiving and Incorporating Health Information measures are scoring low is that they cannot get others to exchange CCDAs with them because of this difficulty. CMS has heard this complaint but is still requiring that providers electronically exchange care coordination information. These two measures combined are worth 40% of a clinician or group’s total Promoting Interoperability score. 

To assist providers in their ability to successfully exchange information through direct messaging, the Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare and Medicaid Services (CMS), under the 21^st Century Cures Act Final Rule, now mandate a centralized directory of provider electronic addresses for data exchange published by the National Plan & Provider Enumeration System (NPPES) as part of the requirements to promote interoperability. The NPPES system is searchable through a public API and will allow providers to look up the direct messaging address of any other provider. Failure to enter this information could constitute information blocking, which is a key driver and a principal focal point of the Final Rule. Providers must enter this information into the NPPES system by June 30, 2020 or they will be publicly reported as noncompliant in the second half of 2020.

What is Direct Messaging?

Direct Messaging is a technical term used for securely exchanging health information between physicians, hospitals and other healthcare providers. It functions just like email but also meets the rigid privacy and security measures of HIPAA. Messages sent through Direct Messaging are encrypted, unlike regular emails.

Direct Messaging goes beyond the traditional email or fax by giving the ability to pull specific information directly into the patient’s EHR and allowing information to be shared between different systems. Direct secured messaging remains a preferred mechanism for the exchange of health information between healthcare entities. Each provider has a distinct direct address that has been given by their EHR vendor or other source.

How to Enter Your Direct Secure Messaging Address in NPPES

In NPPES, the providers can enter their Endpoint information when they request new NPIs or when they update their NPI information. The Endpoint details can be entered on both Individual (Type 1) and Organization (Type 2) NPI applications. Endpoints should not include personal email information. When entering an Endpoint, you are required to enter the Endpoint Type such as Direct Messaging Address or FHIR URL, among other types. You can access the NPPES website using this link.

You can select the Endpoint Location from the list of addresses in the dropdown list or select “Enter a new Endpoint Location.” The list of addresses in the dropdown box will consist of all Practice Location and Endpoint addresses associated with your NPI, as well as the Practice Locations and Endpoint Locations associated with the Endpoint Affiliated Organization if one has been selected from NPPES.

If you select “Enter a new Endpoint Location,” you can manually enter your direct messaging address. This new location information will go through an address standardization check and you will have the option of choosing the standardized address or using the input address. If your Direct Messaging address changes in the future, you will be required to correct it in the NPPES within 30 days. 

Since Direct Messaging is a secure means of communication, when you obtain your Direct address, you may be asked to provide information that confirms your identity to ensure sensitive patient health information is protected.

If you have questions about your direct messaging address, please check with your Nextech Account Manager. For more information about NPPES, please see the following links for additional resources:

CMS 21st Century Cures Act Final Rule

NPPES Health Information Exchange Page

CMS Interoperability & Patient Access Final Rule

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