Taxonomy Code Requested on Claim Submissions – Portal Claims

The Office of fb88Care Services (OMS) is requesting that providers include the taxonomy code on all claims.ÌýThe taxonomy code is necessary for the Centers for Medicaid and Medicare Services (CMS) to collect data for Transformed Medicaid Statistical Information System (T-MSIS) reporting. This data helps to inform states of their current standing in data quality as compared to other states and is crucial for research and policy on Medicaid and CHIP. The taxonomy is also used byÌý CMS to conduct program oversight, administration, and integrity.ÌýÌý

The taxonomy code can be reported on each claim in the following fields for each type of submission: ÌýÌý

Electronic Claim Submissions:Ìý

837P - CMS 1500Ìý

Rendering provider – Loop 2310B Segment PRV03.Ìý Billing provider - Loop 2000A Segment PRV03.ÌýÌý

837I - UB04 claimÌý

Billing provider - Loop 2000A Segment PRV03.ÌýÌý

837D – DentalÌý

Rendering provider – Loop 2310B Segment PRV03.Ìý Treating provider - Loop 2000A Segment PRV03.Ìý

Paper Claim Submissions:Ìý

CMS 1500Ìý

The billing and/or rendering provider taxonomy will be captured.Ìý

Rendering ProviderÌýÌý      Box 19ÌýÌý

•    Qualifier ZZÌý

•    Taxonomy codes reported in this field must not be reportable in other fields, i.e., Item Numbers 17, 24J, 32, or 33. Ìý

Ìý•    When reporting a second item of data, enter three blank spaces and then the next qualifier and number/code/information.ÌýÌý

 â¶Ä¯â¶Ä¯â¶Ä¯â¶Ä¯â¶Ä¯â¶Ä¯â€¯ORÌý

      Box 24J - In the shaded portionÌýÌý

Billing ProviderÌýÌý      BOX 33BÌý

  • Place the taxonomy code in box 33B proceeded with the ZZ qualifier for the billing levelÌýÌý
  • UB04Ìý

Billing ProviderÌý     Form Locator 81Ìý

•    Qualifier “B3â€Ìý

•    taxonomy codeÌý

DentalÌý

ADA Dental Claims - Treating DentistÌýÌý

  • Box 56A Provider Specialty Code (Taxonomy)Ìý

PORTALÌý

There is no field on the portal to enter the taxonomy code. Note that claims entered on the portal are pre-populated with a taxonomy code.Ìý

​​If you have any questions, please contact Provider Services at: 1-866-690-5585.​Ìý

Questions about EVV implementation?

See theÌýEVV WebpageÌýfor more information, including Frequently Asked Questions (FAQ).

Please contact Provider Services with questions:

  • Email fb88Care'sÌýEVV email box
  • Call Provider Services at 1-866-690-5585, option 3.