Provider Characteristics Code Set

Code Set Resources

The following resources for the Provider Characteristics code set are available from the "Provider Characteristics" drop-down menu:

Code Lookup is the complete list of Health Care Provider Characteristics codes.

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.

PDF is where you can view, save, and print a PDF version of the current code set.

CSV is where you can download a Comma Separated Values (CSV) version of the code set.

Vendors interested in incorporating the Provider Characteristics code set into their commercial products must complete the license request form found on the CSV page.

Background Information

The Provider Characteristics code set is for use with health care provider information for enrollment and credentialing transactions and their corresponding responses. It is intended to provide codified responses to questions presented to a health care provider applying to or registering with an entity and to report the outcome of such application or registration. It may also be used for responses to inquiries regarding provider participation or registration in a program or plan.

This is not intended to be a comprehensive list of services rendered by a health care provider.

This code set was formulated so that the absence of information is a meaningful statement and should describe the most common situation. (i.e. "2S" = x-rays are provided at this location. No data transmitted means x-rays are not provided, "2S" transmitted means x-rays are provided.) New statements should follow this guideline and should be screened so that conflicting information is not introduced (do not add "provider is participating" AND "provider is not participating". Select the least common statement to add to the list).

Code Request/Change Criteria

To request new codes or modifications to existing codes, send an email to: This email address is being protected from spambots. You need JavaScript enabled to view it..