Health Care Provider Taxonomy
Code Set Resources
The following on the Health Care Provider Taxonomy code set are available from the "Provider Taxonomy" drop-down menu:
On-line Lookup is the complete list of Health Care Provider Taxonomy codes. Click on names with a plus sign to expand the list and few the additional codes. Click on the word "definition" to view the definition of the code.
Questions is where you can submit a question about the code set.
More Information is a list of FAQs about the code set and how to use it.
New Codes is a complete list of new codes that have been added to the code set since the last update.
Modifications is a complete list of modifications that have been made to the code set since the last update.
PDF is where you can download a PDF version of the current or previous versions of the code set.
CSV is where you can download a Comma Separated Values (CSV) version of the code set.
Vendors interested in incorporating the Health Care Provider Taxonomy code set into their commercial products must complete the license request form found on the CSV page.
The Health Care Provider Taxonomy code set is an external, nonmedical data code set designed for use in an electronic environment, specifically within the ASC X12N Health Care transactions. This includes the transactions mandated under HIPAA.
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Grouping, Classification, and Area of Specialization.
The National Uniform Claim Committee (NUCC) is presently maintaining the code set. It is used in transactions specified in HIPAA and the National Provider Identifier (NPI) application for enumeration. Effective 2001, the NUCC took over the administration of the code set. Ongoing duties, including processing taxonomy code requests and maintenance of the code set, fall under the NUCC Code Subcommittee.
Code Request/Change Criteria
The following are the criteria that are used to evaluate change requests to the Health Care Provider Taxonomy code set:
- Request meets a national need; do not request on the basis of a state or local need only.
- Exception – Provider is recognized, i.e., licensed, certified, or registered, as a health care provider in one or few states, but needs to obtain an NPI.
- Request meets a need not currently in the code set.
Only one (1) of the following needs to be met.
- Identify a health care provider in electronic transaction(s)
- Categorize health care providers in a provider directory
- Apply for an NPI for a health care provider (as defined by HIPAA)
- Identify health care provider practice focus or education/training for enrollment with health plans
- Identify health care providers in local, regional or national health information exchange
- Identify health care providers in public health-related data transactions
If you are unable to select any criteria from the previous list, but still believe that you qualify for a taxonomy code, it is acceptable to fill out the request form.
Meeting one or more of the following provides additional business justification of the need for a code:
For physician codes:
- Certification by American Board of Medical Specialties (ABMS) or American Osteopathic Association certifying boards.
- Accredited residency or subspecialty training program by the Accreditation Council for Graduate Medical Education (ACGME).
For all codes:
Existence of a nationally recognized specialty board, or a specialty defined by a subspecialty certification or a certificate of special competence issued by such a board or a nationally recognized accrediting body, or recognized by a regulatory agency.
Additional criteria considered for request to change existing codes or definitions.
- Demand for services is such that a significant number of providers choose to limit their practice to that specialty
- The specialty is based on major new concepts in health science having broad professional support
- The specialty is a distinct and well-defined new field of health care that entails special concern with the problems of a specific patient group, organ system, disease entity, or health care procedure
Additional criteria considered for request to change existing codes and/or definitions:
- Recommended change will not affect individuals/organizations currently using the existing code or definition.
- Recommended change will not exclude any subset of individuals/organizations to be identified by the changed code or definition.