What does a taxonomy code look like?
What is a taxonomy code?
A taxonomy code is a ten-character alphanumeric code that allows you to describe your specialty to an insurance payer. The Health Care Provider Taxonomy code set is a nonmedical data code set intended for use in an electronic environment, specifically in ASC X12N Health Care transactions. This includes the HIPAA-mandated transactions.
The taxonomy code is a ten-character alphanumeric code that is unique. Provider Grouping, Classification, and Area of Specialization are the three distinct “Levels” of the code set.
Level I, Provider Grouping
It includes a major grouping of healthcare provider service(s) or occupation(s). For instance, allopathic and osteopathic physicians, dentists, hospitals, etc.
Level II, Classification
A service or profession that is more specific to the Provider Grouping. The classification of allopathic and osteopathic physicians, for example, is based on the General Specialty Certificates provided by the relevant national boards.
Level III, Area of Specialization
A more specialized section of the Classification in which a provider wishes to practice or offer services. The Area of Specialization for grouping Allopathic and Osteopathic Physicians, for example, is focused on Subspecialty Certificates provided by the relevant national boards.
Who needs taxonomy codes?
Everyone who provides Medicare services need taxonomy codes.
You must first participate in the Medicare program to become a Medicare provider and file Medicare claims. You must have an NPI to enroll. To obtain an NPI, you must include the taxonomy code that corresponds to your classification and specialization in your application.
What does a taxonomy code look like?
Taxonomy codes are ten characters long, alphanumeric, and often end in the letter X. The Level 2 Classification is indicated by the first four characters of a taxonomy code.
The middle five characters vary depending on the Level 3 Area of Specialization. For example, the code for Pediatric Cardiology is (2080P0202X). The “2080” in it means that it belongs to the Pediatrics category (208000000X).
The prefix “P0202” distinguishes it from specialties such as Pediatric Endocrinology (2080P0205X) or Pediatric Nephrology (2080P0205X) (2080P0210X).
