What is a taxonomy code?
Taxonomy codes are administrative codes set up for health care providers to classify the type of provider and the region of specialization. Each taxonomy code is a unique alphanumeric code of ten characters that allows providers to define their specialty at the claim level. Taxonomy codes are assigned at both the individual provider and organizational provider level.
There are three distinct levels of taxonomy codes: Level I is the provider category, Level II is classification, and Level III is the Specialization Field. A full list of taxonomy codes can be found on the Washington Publishing Company’s (WPC) website under the Health Insurance Portability and Accountability Act (HIPAA) related code list section http://www.wpc-edi.com/products/codelists/alertservice.
The Purpose of Taxonomy Codes
Taxonomy codes are intended for use in an electronic environment, mainly within ASC X12N Health Care transactions and some compulsory transactions of HIPAA. Taxonomy codes are also used when applying for a National Patient Identifier (NPI) with the National Plan and Provider Enumeration System (NPPES).
How do I get a taxonomy code?
Use the National Uniform Claim Committee (NUCC) code setlist to find the taxonomy code which describes your provider category, classification, or specialization most closely.
How can I access the taxonomy code data set?
A crosswalk of taxonomy codes has been developed by CMS that connects the categories of providers and suppliers that are eligible to apply for Medicare program enrollment with the relevant taxonomy codes for healthcare providers.
Finding your taxonomy code is easy. Here’s how:
- Visit https://npiregistry.cms.hhs.gov/
- Enter your NPI Number into the field, then click Search.
Why is it important that I select the correct taxonomy code?
Many insurers require the use of taxonomy codes to issue billing credentials, process health insurance claims, and assess network adequacy, in addition to directing the selection of a suitable taxonomy code when applying for an NPI. Therefore, to ensure proper payment of claims, providers must choose the taxonomy code that most closely matches their specialty.