Roster Billing

A billing arrangement where individual providers bill under a group practice's NPI and tax ID, with each provider listed as the rendering provider on their respective claims.

Roster billing is how group practices handle claims submission. The group bills under its Type 2 NPI and tax identification number, and each individual provider in the group appears as the rendering provider on the claims for services they personally performed. This setup requires proper enrollment linkage. The group must have an active enrollment with the payer (CMS-855B for Medicare, or the payer's group enrollment for commercial plans). Each individual provider must also be enrolled and have their benefits reassigned to the group. If either piece is missing, claims deny. The term "roster" comes from the provider roster that groups maintain with each payer. The roster lists every provider who is authorized to bill under the group's NPI. When a new provider joins the group, they must be added to the roster with each payer. When a provider leaves, they must be removed. Failure to update rosters promptly is one of the most common administrative errors in group practices. Adding a provider to a payer's roster can be quick or slow depending on the payer. Some payers process roster additions in a few days if the provider is already individually credentialed. Others treat a roster addition as a new enrollment that goes through the full credentialing process, which can take months. For Medicare, roster additions and changes are handled through PECOS. You update the group's CMS-855B to add or remove providers, or the individual provider updates their CMS-855I to add a reassignment to the group. Both approaches work, but the processing time depends on the MAC. A common pitfall: a provider leaves one group and joins another, but nobody removes them from the old group's roster. The old group could theoretically continue billing under that provider's NPI. This is a compliance risk. Make sure departing providers are removed from your roster with every payer, and confirm with PECOS that their reassignment to your group has been terminated.