A taxonomy code is a code that indicates the type, classification, and area of expertise of a Provider or Organization. Individuals & Groups of Individuals and Non-Individuals are the two components of the taxonomy code set.
Each taxonomy code is a ten-character alphanumeric identifier that identifies a provider’s specialization at the claim level.
The type, classification, and area of specialization of the Provider or Organization are represented by a taxonomy code.
There are two sections to the taxonomy code set: Individuals and Individual Groups and Non-Individuals.
The NUCC keeps track of these codes, which providers use to identify their area of expertise.
According to ABC, some payers are now requesting a provider’s taxonomy code to define the provider’s specialty designation(s) throughout the enrollment process.
Why Are They Important?
Taxonomy codes allow providers to define their specialization at the claim level, impacting the payments from insurance providers directly.
If you have an incorrect taxonomy code associated with your NPI number, your services can be charged at a lower reimbursement rate or rejected instantly by an insurance provider.
What is the taxonomy code for primary care physicians?
Primary Care Taxonomy Code is 363LP2300X.
How many Taxonomy codes can a provider have?
A provider may have more than one code for taxonomy. When filing claims, it’s critical to register all accessible taxonomy codes with NPPES and use the correct taxonomy code to indicate the required expertise.
This would aid in the more precise and timely management of claims.
Why do I need to know my taxonomy code(s)?
Taxonomy codes are used as a secondary identification in HIPAA transactions to verify that a provider is accurately identified.
Where do I find my taxonomy code?
To find the taxonomy code that most closely describes your provider type, classification, or specialization, use the National Uniform Claim Committee (NUCC) code set list.
How often are taxonomy codes updated?
The code set is published and released twice a year, in January and July.