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How To Become A Health Care Provider

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Institutional:

Code Description

0A Intern/Residency Hospital Plan

0B Intern/Residency Uniform Pre-Payment (U.P.P.) 0C Freestanding Dialysis

0D Coordinated Home Care 0E Plan Hospital

0F Uniform Pre-Payment (U.P.P.) Hospital 0G Freestanding Surgicenter

0H State Hospital

0I Foreign Hospital (outside of U.S.A) 0J Christian Science Sanitarium

0K Freestanding Physical Therapy Center

0L Freestanding Alcohol & Substance Abuse Treatment Center 0M Alcohol & Substance Abuse - Outpatient Only

0N Non-Plan Provider 0O Extended Care Facility 0P Out-of-State Plan Hospital

0Q Medicare Approved Extended Care Facility (ECF) 0R Ambulance

0S Hospice (Plan)

0T Medicare Approved Home Heath Service (Coordinated Home Care) 0U Medicare Approved Freestanding Dialysis Center

0V State Licensed Ambulatory Surgicenter 0W JCAH Approved Extended Care Facility (ECF)

0X JCAH Approved Alcohol Rehabilitation (Inpatient & Outpatient) 0Y Nursing Home

0Z Contracted Provider Affiliation FE Free Standing ER

FR Free Standing Rehab IH Inpatient Hospital Psych LT Long Term Acute Care OF Occupational Therapy Facility PF Physical Therapy Facility

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RH Rural Health Provider SF Skilled Nursing Facility ST Speech Therapy Facility TH Birthing Center

TI Psychiatric/Partial Day Hospital TJ Rehabilitation Hospital

T1 Non-Member Hospital T2 Government Hospital

T5 Renal Dialysis – Non-Contracting

Professional:

Code Description

Medical Initials

A0 Chiropractor D.C.

A1 Regular Medical Doctor, Medical Genetics (Ind) M.D.

A2 Podiatrist D.P.M., D.S.C.

A3 Dentist D.D.S., D.M.D.

A4 Radiology Technician, Laboratory Technician, Bacteriologist/Microbiologist -- A5 Group Medical Practice, Clinic or Mixed Therapy Group, Medical Genetics (Grp) --

A6 Osteopath, Medical Genetics (Ind) D.O.

A7 Physical Therapist R.P.T

A8 Clinical Psychologist or Neuropsychologist Ph.D.

A9 Registered Nurse R.N.

AB Hospital Based Physician, Medical Genetics (Ind) --

AC Ambulance Service --

AD Prosthetic-Orthotic Devices --

AE Durable Medical Equipment --

AF Optometrist O.D.

AG Optician --

AH Hearing Aid Supplier --

AI Audiologist --

AJ Christian Science Healer --

AK Paramedic --

AL Clinical Social Worker or Licensed Clinical Social Worker C.S.W, L.C.S.W

AM Pharmacist --

AN Home Health Agency H.H.A.

AP Pastoral Counselor --

AQ Registered Dietician --

AR Licensed Physician Assistant L.P.A.

AS Occupational Therapist O.T, O.T.R.

AT Speech Therapist S.T., R.S.T., S.L.P., S.P.T.

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Code Description

Medical Initials

AV Podiatry Group --

AW Clinical Psychiatry Group or Neuropsychologist Group --

AX Registered Nurse Group R.N.

AY Chiropractic Group D.C.

AZ Osteopath Group D.O.

B0 Naprapath Individual D.N.

B1 License Clinical Professional Counselor L.C.P.C.

B2 Acupuncturist (Individual) L.Ac.

B3 Home Infusion Therapist Group --

B4 Massage Therapist --

B5 License Clinical Professional Counselor Group L.C.P.C.

B6 Licensed Clinical Social Worker Group L.C.S.W.

B7 Physical Therapy Group P.T., R.P.T., L.P.T.

B8 Rural Health Clinic --

B9 Advanced/Registered Nurse Practitioner R.N.P.

BA Licensed Marriage & Family Therapist L.M.F.T.

BB Hospital Based Physician Group, Medical Genetics (Grp) --

BC Registered Nurse First Assistant --

BD Prosthetic – Orthotic Group --

BE Surgical Assistant --

BF Optometrist Group O.D.

BG Optician Group --

BI Audiologist Group --

BL Certified Registered Nurse Anesthetist C.R.N.A.

BM Skilled Nurse/Home Health Aide/Durable Medical Equipment (DME) Therapy Group --

BN Skilled Nurse Therapist Group --

BP Specialty Pharmacy --

BQ Nutritionist/Dietician Group --

BR Licensed Physician Assistant Group L.P.A.

BS Occupational Therapist Group O.T., R.O.T., O.T.R.

BT Speech Therapist Group S.T., R.S.T., S.L.P.

BU Mixed Therapy – Occupational Physical Speech

BV Certified Diabetes Educator --

BW Licensed Midwife --

BX Certified Nurse Specialist/Individual C.N.S.

BY Naprapath Group D.N.

CA Licensed Marriage & Family Therapist Group L.M.F.T. CB Imaging Center

CC Registered Nurse First Assistant Group --

CD Certified Nurse Practitioner/Individual C.N.P.

CE Surgical Assistant Group --

CH Doctor of Oriental Medicine Group --

CI Early Intervention Specialist Individual CG Early Intervention Specialist Group

CP Certified Nurse Practitioner C.N.P.

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Code Description

Medical Initials

CW Licensed Midwife Group --

CX Certified Nurse Specialist/Group C.N.S.

C0 Licensed Clinical Social Worker Group, Licensed Clinical Professional Counselor Group L.C.S.W., L.C.P.C.

C2 Acupuncture Group --

C4 Massage Therapist Group --

C9 Advance/Registered Nurse Practitioner Group R.N.P.

DA License Genetic Counselor (Individual)

DD Certified Nurse Practitioner Group C.N.P.

DP Certified Nurse Practitioner Group C.N.P.

DW Certified Nurse Midwife Individual C.N.M

D4 License Genetic Counselor Group D6 Behavioral Health Mixed Specialty Group D7 Telemedicine Group

D8 Licensed Social Worker Individual D9 Dietitian Individual

E1 Lactation Consultant Individual E2 Lactation Consultation Group

E3 Physical Therapy Assistant - Individual PTA

E4 Occupational Therapy Assistant - Individual OTA

E5 Speech Therapy Assistant - Individual SLPA

EW Certified Nurse Midwife Group C.N.M

F1 Federally Qualified Health Center (FQHC) F2 Family Planning

F4 Immunization Clinic Pharmacy

FW Licensed Practical Nurse L.P.N

IC Immunization Clinic

ID Independent Diagnostic Testing Facility IR Immediate Care Centers

IS Ambulatory Infusion Suites

HA Board Certified Behavioral Analyst Individual HB Assistant Behavioral Analyst Group

HC Doctorial Behavioral Analyst Group HD Doctorial Behavioral Analyst Individual HG Board Certified Behavioral Analyst Group HP Hospitalist Individual

HS Assistant Behavioral Analyst Individual PD Cardio Pulmonary Diagnostic Testing PH Pharmacist

RT Respiratory Therapist Individual SI Free Standing Imaging Center SL Sleep Lab

SS Home Sleep Study

TA Advanced Nurse Practitioner R.N.P.

TB Licensed Practical Nurse Group L.P.N

TC Licensed Professional Counselor L.P.C.

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Code Description

Medical Initials

TE Home Infusion Therapist --

TF Licensed Chemical & Dependency Counselor --

TG Athletic Trainers Group TK Athletic Trainer (Individual)

T4 Licensed Marriage & Family Therapist L.M.F.T.

T6 Disease Management/Education --

T7 Licensed Psychological Associates --

T8 Certified Registered Nurse Anesthetist C.R.N.A.

T9 Certified Registered Nurse Anesthetist Group C.R.N.A. WS Wellness Screening

YZ Foreign Provider (Outside U.S.A.) --

References

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