Q.What are the health care provider taxonomy codes that the Health Insurance Portability and Accountability Act (HIPAA) mandates we use when filing some electronic claims? Where can I get a copy of the codes?
A. Under HIPAA, code sets that characterize a general administrative situation, rather than a medical condition or service, are referred to as nonclinical or nonmedical code sets. The health care provider taxonomy code set is an external, nonmedical data code set for classifying health care providers according to provider type or practitioner specialty in an electronic environment. Requirements to report the code vary from one health plan to another.
View the code set here. If needed, select the taxonomy code(s) that most closely represents your education, license, or certification. In cases where more than one taxonomy code applies, a health plan may prefer that you use one over another when submitting claims for certain services.
The National Uniform Claim Committee (NUCC) maintains code set and updates it twice a year, in April and October.
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Last Updated On
June 03, 2016