Return to contents

ProviderCodes In the absence of an all-encompassing Provider Classification System, both X12N and the National Provider System Workgroup from the Centers for Medicare and Medicaid Services (CMS) commenced work on identifying and coding an external provider table that would be able to codify provider type and provider area of specialization for all medical related providers. CMS' intent was to provide a single coding structure to support work on the National Provider System, while X12N needed a single common table for trading partner use. The two projects worked independently to some extent until April 1996 when the lists were coordinated and a single taxonomy was proposed. A sub-group of the X12N TG2 WG 15 was charged with resolving differences in the two proposed taxonomies. Their work resulted in a single taxonomy that both CMS and members of X12N found meaningful, easy to use, and functional for electronic transactions. The sub-group initially started with the CMS draft taxonomy. This list incorporated all types of providers associated with medical care in various ways. Many of the providers listed, such as technologists or technicians, support or repair equipment/machinery. A number of the providers offer medical services, in concert with others, and do not or cannot bill independently for their portion. The amount of research to validate and classify all providers using the proposed hierarchical structure was enormous. The X12N sub-group focused on medical providers who are licensed practitioners, those who bill for health-related services rendered, and those who appeared on the Medicare CMS Provider Specialty listing. This included providers who were licensed to practice medicine via state licensure agencies. In addition, a very broad definition of "areas of specialization" was used, which included nationally recognized specialties, provider self-designated specialties, areas of practice focus, and any request by any agency or trading partner submitted before the first taxonomy release. This level of detail captured specialty information in categories detailed enough to support those trading credentialing information, yet broad enough to support those wishing to trade directory level specialization information. In 2001, ANSI ASC X12N asked the NUCC to become the official maintainer of the Health Care Provider Taxonomy List. The NUCC has a formal operating protocol and its membership includes representation from key provider and payer organizations, as well as state and federal agencies, standard development organizations and the National Uniform Billing Committee (NUBC). Criteria for membership includes a national scope and representation of a unique constituency affected by health care electronic commerce, with an emphasis on maintaining a provider/payer balance.
Lvl | Type, Domain name and/or Mnemonic code | Concept ID | Mnemonic | Print Name | Definition/Description
--- | --- | --- | --- | --- | ---
1 | S: AgenciesProviderCodes (250000000X) | S20669 | 250000000X | Agencies | A non-facility provider that renders outpatient outreach services that are not provided at a specific location. The licensure or registration is assigned to the agency rather than to the individual practitioners as would be the case in a group practice.
2 | L: (251B00000X) | C20670 | 251B00000X | Case Management |
2 | L: (251C00000X) | C20671 | 251C00000X | Day Training, Developmentally Disabled Services | These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in theri homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning.
2 | L: (251E00000X) | C20672 | 251E00000X | Home Health |
2 | L: (251F00000X) | C20673 | 251F00000X | Home Infusion |
2 | L: (251G00000X) | C20674 | 251G00000X | Hospice Care, Community Based |
2 | L: (251J00000X) | C20675 | 251J00000X | Nursing Care |
2 | L: (251K00000X) | C20676 | 251K00000X | Public Health or Welfare |
2 | L: (251V00000X) | C20677 | 251V00000X | Voluntary or Charitable |
1 | S: AllopathicandOsteopathicPhysiciansProviderCodes (200000000X) | S20096 | 200000000X | Allopathic & Osteopathic Physicians | A broad category grouping state licensed providers in allopathic or osteopathic medicine whose scope of practice is determined by education.
2 | S: AllergyandImmunologyProviderCodes (207K00000X) | S20097 | 207K00000X | Allergy & Immunology |
3 | L: (207KA0200X) | C20098 | 207KA0200X | Allergy |
3 | L: (207KI0005X) | C20099 | 207KI0005X | Clinical & Laboratory Immunology |
2 | S: AnesthesiologyProviderCodes (207L00000X) | S20100 | 207L00000X | Anesthesiology |
3 | L: (207LA0401X) | C20101 | 207LA0401X | Addiction Medicine |
3 | L: (207LC0200X) | C20102 | 207LC0200X | Critical Care Medicine |
3 | L: (207LP2900X) | C20103 | 207LP2900X | Pain Mediciine |
2 | L: (208U00000X) | C20104 | 208U00000X | Clinical Pharmacology |
2 | L: (208C00000X) | C20105 | 208C00000X | Colon & Rectal Surgery |
2 | S: DermatologyProviderCodes (207N00000X) | S20106 | 207N00000X | Dermatology |
3 | L: (207NI0002X) | C20107 | 207NI0002X | Clinical & Laboratory Dermatological Immunology |
3 | L: (207NS0135X) | C20108 | 207NS0135X | Dermatological Surgery |
3 | L: (207ND0900X) | C20109 | 207ND0900X | Dermatopathology |
3 | L: (207ND0101X) | C20110 | 207ND0101X | MOHS-Micrographic Surgery |
3 | L: (207NP0225X) | C20111 | 207NP0225X | Pediatric Dermatology | A dermatologist trained to diagnose and treat pediatric patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles, and other tumors of the skin, the management of contact dermatitis, and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars, and the skin changes associated with aging. A subspecialty certificate was approved by ABMS in 2000. ACGME Accredited Residency Program Requirements: None.
2 | S: EmergencyMedicineProviderCodes (207P00000X) | S20112 | 207P00000X | Emergency Medicine |
3 | L: (207PE0004X) | C20113 | 207PE0004X | Emergency Medical Services |
3 | L: (207PT0002X) | C20114 | 207PT0002X | Medical Toxicology |
3 | L: (207PP0204X) | C20115 | 207PP0204X | Pediatric Emergency Medicine |
3 | L: (207PS0010X) | C20116 | 207PS0010X | Sports Medicine |
3 | L: (207PE0005X) | C20117 | 207PE0005X | Undersea and Hyperbaric Medicine | A specialist who treats decompression illness and diving accident cases and uses hyperbaric oxygen therapy to treat such conditions as carbon monoxide poisoning, gas gangrene, non-healing wounds, tissue damage from radiation and burns, and bone infections. This specialist also serves as a consultant to other physicians in all aspects of hyperbaric chamber operations, and assesses risks and applies appropriate standards to prevent disease and disability in divers and other persons working in altered atmospheric conditions. A subspecialty certificate was approved by ABMS in 2000. ACGME Accredited Residency Program Requirements: None
2 | S: FamilyPracticeProviderCodes (207Q00000X) | S20118 | 207Q00000X | Family Practice |
3 | L: (207QA0401X) | C20119 | 207QA0401X | Addiction Medicine |
3 | L: (207QA0000X) | C20120 | 207QA0000X | Adolescent Medicine |
3 | L: (207QA0505X) | C20121 | 207QA0505X | Adult Medicine |
3 | L: (207QG0300X) | C20122 | 207QG0300X | Geriatric Medicine |
3 | L: (207QS0010X) | C20123 | 207QS0010X | Sports Medicine |
2 | L: (208D00000X) | C20124 | 208D00000X | General Practice |
2 | L: (208M00000X) | C20125 | 208M00000X | Hospitalist |
2 | S: InternalMedicineProviderCodes (207R00000X) | S20126 | 207R00000X | Internal Medicine |
3 | L: (207RA0401X) | C20127 | 207RA0401X | Addiction Medicine |
3 | L: (207RA0000X) | C20128 | 207RA0000X | Adolescent Medicine |
3 | L: (207RA0201X) | C20129 | 207RA0201X | Allergy & Immunology |
3 | L: (207RC0000X) | C20130 | 207RC0000X | Cardiovascular Disease |
3 | L: (207RI0001X) | C20131 | 207RI0001X | Clinical & Laboratory Immunology |
3 | L: (207RC0001X) | C20132 | 207RC0001X | Clinical Cardiac Electrophysiology |
3 | L: (207RC0200X) | C20133 | 207RC0200X | Critical Care Medicine |
3 | L: (207RE0101X) | C20134 | 207RE0101X | Endocrinology, Diabetes & Metabolism |
3 | L: (207RG0100X) | C20135 | 207RG0100X | Gastroenterology |
3 | L: (207RG0300X) | C20136 | 207RG0300X | Geriatric Medicine |
3 | L: (207RH0000X) | C20137 | 207RH0000X | Hematology |
3 | L: (207RH0003X) | C20138 | 207RH0003X | Hematology & Oncology |
3 | L: (207RI0008X) | C20139 | 207RI0008X | Hepatology | The discipline of Hepatology encompasses the structure, function, and diseases of the liver and biliary tract. The American Board of Internal Medicine considers Hepatology part of the subspecialty of gastroenterology. Physicians who identify themselves as Hepatologists usually, but not always, have been trained in gastrointestinal programs. Training Programs, and/or Fellowships, Preceptorships: The American Association for the Study of Liver Diseases (AASLD) is the major professional society organized for physicians with an interest in Hepatology. A subcommittee of that organization has published guidelines for training programs in the 1992 November issue of Hepatology. Source: The American Board of Internal Medicine 9/1993 ACGME Accredited Residency Program Requirements: None
3 | L: (207RI0200X) | C20140 | 207RI0200X | Infectious Disease |
3 | L: (207RI0011X) | C20141 | 207RI0011X | Interventional Cardiology | Interventional Cardiology is a field within Cardiology. Interventional Cardiology involves the use of specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and the use of technical procedures and medications to treat abnormalities that impair the function of the heart. Therapeutic interventional cardiac procedures are performed in special clinics or hospital-based laboratories. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine)
3 | L: (207RM1200X) | C20142 | 207RM1200X | Magnetic Resonance Imaging (MRI) |
3 | L: (207RX0202X) | C20143 | 207RX0202X | Medical Oncology |
3 | L: (207RN0300X) | C20144 | 207RN0300X | Nephrology |
3 | L: (207RP1001X) | C20145 | 207RP1001X | Pulmonary Disease | See Definitions for Pulmonary Disease and Critical Care Medicine. ACGME Accredited Program Requirements: 3 years of training with 3 years in Internal Medicine for a total of 6 years.
3 | L: (207RR0500X) | C20146 | 207RR0500X | Rheumatology |
3 | L: (207RS0010X) | C20147 | 207RS0010X | Sports Medicine |
2 | L: (209800000X) | C20148 | 209800000X | Legal Medicine | Legal Medicine is a special field of medicine that focuses on various aspects of medicine and law. Historically, the practice of legal medicine made contributions to medicine as a scientific instrument to solve criminal perplexities. Since World War II, the domain of legal medicine has broadened to include not only aspects of medical science to solve legal and criminal problems but aspects of law as it applies to medicine. Legal Medicine continues to grow as medicolegal issues like medical malpractice and liability, government regulation of health care, issues of tort reform, and moral and ethical complexities presented by technological advances become increasingly prominent. Many medical schools have implemented courses which supply medicolegal instruction for medical students, and many law schools now offer medicolegal courses. Also, dual degree programs in law and medicine have been created to assist physicians to bridge the gap between medicine and the law. Source: American Board of Legal Medicine 08/1992 Training Programs, and/or Fellowships, Preceptorships: Certification available through the American Board of Legal Medicine. ACGME Accredited Residency Program Requirements: None
2 | S: MedicalGeneticsProviderCodes (207S00000X) | S20149 | 207S00000X | Medical Genetics |
3 | L: (207SG0202X) | C20150 | 207SG0202X | Clinical Biochemical Genetics |
3 | L: (207SC0300X) | C20151 | 207SC0300X | Clinical Cytogenetics | A clinical cytogenetcist demonstrates competence in providing laboratory diagnostic and clinical interpretive services dealing with cellular components, particularly chromosomes, associated with heredity. A general certificate was first issued by the ABMS in 1982. ACGME Accredited Residency Program Requirements: None.
3 | L: (207SG0201X) | C20152 | 207SG0201X | Clinical Genetics (M.D.) |
3 | L: (207SG0203X) | C20153 | 207SG0203X | Clinical Molecular Genetics |
3 | L: (207SM0001X) | C20154 | 207SM0001X | Molecular Genetic Pathology | Molecular Genetic Pathology is a subspecialty of Medical Genetics. A molecular genetic pathologist is an expert in the principles, theory, and technologies of molecular biology and molecular genetics. This expertise is used to make or confirm diagnoses of Mendelian genetic disorders, of human development, infectious diseases and malignancies, and to assess the natural history of those disorders. A molecular genetic pathologist provides information about gene structure, function, and alteration and applies laboratory techniques for diagnosis, treatment, and prognosis for individuals with related disorders. A subspecialty certificate for MGG was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development.
3 | L: (207SG0205X) | C20155 | 207SG0205X | Ph.D. Medical Genetics |
2 | L: (207T00000X) | C20156 | 207T00000X | Neurological Surgery |
2 | L: (204D00000X) | C20157 | 204D00000X | Neuromusculoskeletal Medicine & OMM |
2 | L: (204C00000X) | C20158 | 204C00000X | Neuromusculoskeletal Medicine, Sports Medicine |
2 | S: NuclearMedicineProviderCodes (207U00000X) | S20159 | 207U00000X | Nuclear Medicine |
3 | L: (207UN0903X) | C20160 | 207UN0903X | In Vivo & In Vitro Nuclear Medicine |
3 | L: (207UN0901X) | C20161 | 207UN0901X | Nuclear Cardiology |
3 | L: (207UN0902X) | C20162 | 207UN0902X | Nuclear Imaging & Therapy |
2 | S: ObstetricsGynecologyProviderCodes (207V00000X) | S20163 | 207V00000X | Obstetrics & Gynecology |
3 | L: (207VC0200X) | C20164 | 207VC0200X | Critical Care Medicine |
3 | L: (207VX0201X) | C20165 | 207VX0201X | Gynecologic Oncology |
3 | L: (207VG0400X) | C20166 | 207VG0400X | Gynecology |
3 | L: (207VM0101X) | C20167 | 207VM0101X | Maternal & Fetal Medicine |
3 | L: (207VX0000X) | C20168 | 207VX0000X | Obstetrics |
3 | L: (207VE0102X) | C20169 | 207VE0102X | Reproductive Endocrinology |
2 | L: (207W00000X) | C20170 | 207W00000X | Ophthalmology |
2 | L: (204E00000X) | C20171 | 204E00000X | Oral & Maxillofacial Surgery |
2 | S: OrthopaedicSurgeryProviderCodes (207X00000X) | S20172 | 207X00000X | Orthopaedic Surgery |
3 | L: (207XS0114X) | C20173 | 207XS0114X | Adult Reconstructive Orthopaedic Surgery |
3 | L: (207XX0004X) | C20174 | 207XX0004X | Foot and Ankle Orthopaedics | Foot and Ankle Orthopaedics is a discipline of orthopaedic surgery that includes the in-depth study, prevention, and treatment of musculoskeletal diseases, disorders, and sequeiae of injuries in this anatomic region by medical, physical, and surgical methods. ACGME Accredited Residency Program Requirements: 1 year of training with 5 years Orthopedic Surgery for a total of 6 years.
3 | L: (207XS0106X) | C20175 | 207XS0106X | Hand Suvrgery |
3 | L: (207XS0117X) | C20176 | 207XS0117X | Orthopaedic Surgery of the Spine |
3 | L: (207XX0801X) | C20177 | 207XX0801X | Orthopaedic Trauma |
3 | L: (207XX0005X) | C20178 | 207XX0005X | Sports Medicine | Orthopaedic Surgery, Sports Medicine is a subspecialty of Orthopaedics specializing in medical and surgical treatment of musculoskeletal injuries arising from sports. Source: The American Academy of Orthopaedic Surgeons 02/14/1992. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years
2 | S: OtolaryngologyProviderCodes (207Y00000X) | S20179 | 207Y00000X | Otolaryngology |
3 | L: (207YS0123X) | C20180 | 207YS0123X | Facial Plastic Surgery |
3 | L: (207YX0602X) | C20181 | 207YX0602X | Otolaryngic Allergy |
3 | L: (207YX0905X) | C20182 | 207YX0905X | Otolaryngology/Facial Plastic Surgery |
3 | L: (207YX0901X) | C20183 | 207YX0901X | Otology & Neurotology |
3 | L: (207YP0228X) | C20184 | 207YP0228X | Pediatric Otolaryngology |
3 | L: (207YX0007X) | C20185 | 207YX0007X | Plastic Surgery within the Head & Neck |
2 | S: PainMedicineProviderCodes (208V00000X) | S20186 | 208V00000X | Pain Medicine |
3 | L: (208VP0014X) | C20187 | 208VP0014X | Interventional Pain Medicine | Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.
3 | L: (208VP0000X) | C20188 | 208VP0000X | Pain Management |
2 | S: PathologyProviderCodes (207Z00000X) | S20189 | 207Z00000X | Pathology |
3 | L: (207ZP0101X) | C20190 | 207ZP0101X | Anatomic Pathology |
3 | L: (207ZP0102X) | C20191 | 207ZP0102X | Anatomic Pathology & Clinical Pathology |
3 | L: (207ZB0001X) | C20192 | 207ZB0001X | Blood Banking & Transfusion Medicine |
3 | L: (207ZP0104X) | C20193 | 207ZP0104X | Chemical Pathology |
3 | L: (207ZP0105X) | C20194 | 207ZP0105X | Clinical Pathology/Laboratory Medicine |
3 | L: (207ZC0500X) | C20195 | 207ZC0500X | Cytopathology | A cytopathologist is an anatomic pathologist trained in the diagnosis of human disease by means of the study of cells obtained from body secretions and fluids, by scraping, washing, or sponging the surface of a lesion, or by the aspiration of a tumor mass or body organ with a fine needle. A major aspect of a cytopathologist's practice is the interpretation of Papanicolaou-stained smears of cells from the female reproductive systems, the "Pap" test. However, the cytopathologist's expertise is applied to the diagnosis of cells from all systems and areas of the body. He/she is a consultant to all medical specialists. A subspecialty certificate was first issued by the ABMS in 1989. ACGME Accredited Residency Program Requirements: None.
3 | L: (207ZD0900X) | C20196 | 207ZD0900X | Dermatopathology | A dermatopathologist is an expert in diagnosing and monitoring diseases of the skin including infectious, immunologic, degenerative, and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings, and smears of skin lesions by means of light microscopy, electron microscopy, and fluorescence microscopy. A subspecialty certificate was first issued by the ABMS in 1974. ACGME Accredited Residency Program Requirements: None.
3 | L: (207ZF0201X) | C20197 | 207ZF0201X | Forensic Pathology |
3 | L: (207ZH0000X) | C20198 | 207ZH0000X | Hematology |
3 | L: (207ZI0100X) | C20199 | 207ZI0100X | Immunopathology |
3 | L: (207ZM0300X) | C20200 | 207ZM0300X | Medical Microbiology |
3 | L: (207ZP0007X) | C20201 | 207ZP0007X | Molecular Genetic Pathology | Molecular Genetic Pathology is a subspecialty of Pathology. A molecular genetic pathologist is an expert in the principles, theory, and technologies of molecular biology and molecular genetics. This expertise is used to make or confirm diagnoses of Mendelian genetic disorders, of human development, infectious diseases and malignancies, and to assess the natural history of those disorders. A molecular genetic pathologist provides information about gene structure, function, and alteration and applies laboratory techniques for diagnosis, treatment, and prognosis for individuals with related disorders. A subspecialty certificate for MGP was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development.
3 | L: (207ZN0500X) | C20202 | 207ZN0500X | Neuropathology |
3 | L: (207ZP0213X) | C20203 | 207ZP0213X | Pediatric Pathology |
2 | S: PediatricsProviderCodes (208000000X) | S20204 | 208000000X | Pediatrics |
3 | L: (2080A0000X) | C20205 | 2080A0000X | Adolescent Medicine |
3 | L: (2080I0007X) | C20206 | 2080I0007X | Clinical & Laboratory Immunology |
3 | L: (2080P0006X) | C20207 | 2080P0006X | Developmental - Behavioral Pediatrics | Developmental-Behavioral Pediatrics is a subspecialty of Pediatrics. A pediatrician who treats children having developmental delays, or learning disorders, including those associated with visual and hearing impairment, mental retardation, cerebral palsy, spina bifida, autism, and other chronic neurologic conditions. This specialist provides medical consultation and education and assumes leadership in the interdisciplinary management of children with neurodevelopmental disorders. They may also focus on the early identification and diagnosis of neurodevelopmental disabilities in infants and young children as well as on changes that occur as the child with developmental disabilities grows. A subspecialty certificate for DBP was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Early discussions regarding proposal.
3 | L: (2080T0002X) | C20208 | 2080T0002X | Medical Toxicology | Medical Toxicologists evaluate and manage patients with accidental or intentional poisoning through exposure to prescription and non-prescription medications, drugs of abuse, household or industrial toxins, and environmental toxins. These physicians provide consultations through affiliations with regional poison control centers or within their respective medical institutions. The more important areas of Medical Toxicology include but are not limited to the following list subjects: acute pediatric and adult drug ingestion; drug abuse, addiction, and withdrawal; chemical poisoning exposure and toxicity; hazardous materials exposure and toxicity; occupational toxicology; biological poisons; basic concepts of toxicology such as kinetics, dose-response relationships, indices of toxicity and safety standards; basic principles of poison prevention; basic principles of toxic exposure and preventive methodologies. ACGME Accredited Residency Program Requirements: Medical Toxicology (EM) 2 years with 3-4 years Emergency Medicine for a total of 5-6 years; for Medical Toxicology (Preventive Medicine) 2 years with 3 years Preventive Medicine for a total of 5 years. Medical Toxicology (Pediatrics): None. ABMS Approved Subspecialty Certificates (Emergency Medicine) (Pediatrics) (Preventive Medicine)
3 | L: (2080N0001X) | C20209 | 2080N0001X | Neonatal-Perinatal Medicine |
3 | L: (2080P0008X) | C20210 | 2080P0008X | Neurodevelopmental Disabilities | Neurodevelopmental Disabilities is a subspecialty of Pediatrics. A pediatrician who treats children having developmental delays, or learning disorders, including those associated with visual and hearing impairment, mental retardation, cerebral palsy, spina bifida, autism, and other chronic neurologic conditions. This specialist provides medical consultation and education and assumes leadership in the interdisciplinary management of children with neurodevelopmental disorders. They may also focus on the early identification and diagnosis of neurodevelopmental disabilities in infants and young children as well as on changes that occur as the child with developmental disabilities grows. A subspecialty certificate for NDP was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Ongoing early discussions regarding proposal.
3 | L: (2080P0201X) | C20211 | 2080P0201X | Pediatric Allergy & Immunology |
3 | L: (2080P0202X) | C20212 | 2080P0202X | Pediatric Cardiology |
3 | L: (2080P0203X) | C20213 | 2080P0203X | Pediatric Critical Care Medicine | Pediatric Critical Care Medicine focuses on advanced life support for children from term or near term neonate to the adolescent. These physicians are concerned with the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. They also coordinate the multitude of health care plans prescribed for the patient by other involved physicians. In addition, they coordinate and order the priority of health care services provided by the Intensive Care Unit. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics)
3 | L: (2080P0204X) | C20214 | 2080P0204X | Pediatric Emergency Medicine |
3 | L: (2080P0205X) | C20215 | 2080P0205X | Pediatric Endocrinology |
3 | L: (2080P0206X) | C20216 | 2080P0206X | Pediatric Gastroenterology |
3 | L: (2080P0207X) | C20217 | 2080P0207X | Pediatric Hematology-Oncology |
3 | L: (2080P0208X) | C20218 | 2080P0208X | Pediatric Infectious Diseases |
3 | L: (2080P0210X) | C20219 | 2080P0210X | Pediatric Nephrology |
3 | L: (2080P0214X) | C20220 | 2080P0214X | Pediatric Pulmonology |
3 | L: (2080P0216X) | C20221 | 2080P0216X | Pediatric Rheumatology |
3 | L: (2080S0010X) | C20222 | 2080S0010X | Sports Medicine |
2 | S: PhysicalMedicineandRehabilitationProviderCodes (208100000X) | S20223 | 208100000X | Physical Medicine & Rehabilitation |
3 | L: (2081P2900X) | C20224 | 2081P2900X | Pain Medicine | Pain Management is a subspecialty of Physical Medicine & Rehabilitation. A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. A subspecialty certificate for PMR was approved by the ABMS in 1998. ACGME Accredited Residency Program Requirements: Ongoing early discussions regarding proposal.
3 | L: (2081P0010X) | C20225 | 2081P0010X | Pediatric Rehabilitation Medicine | Pediatric Rehabilitation Medicine is a subspecialty of Physical Medicine & Rehabilitation. A physiatrist who utilizes an interdisciplinary approach and addresses the prevention, diagnosis, treatment, and management of congenital and childhood onset physical impairments including related or secondary medical, physical, functional, psychosocial, and vocational limitations or conditions, with an understanding of the life course of disability. This physician is trained in the identification of functional capabilities and selection of the best of rehabilitation intervention strategies, with an understanding of the continuum of care. A subspecialty certificate for PRM was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Early discussions underway
3 | L: (2081P0004X) | C20226 | 2081P0004X | Spinal Cord Injury Medicine | Physicians in the discipline of Spinal Cord Injury addresses the prevention, diagnosis, treatment and management of traumatic spinal cord injury and non-traumatic myelopathies including, on a life-long basis, the prevention, diagnosis and treatment of related medical, physical, psychosocial and vocational disabilities and complications. ACGME Accredited Residency Program Requirements: 1 year of training with 3-5 years in relevant specialty for a total of 4-6 years. ABMS Approved Subspecialty Certificate: (Physical Medicine and Rehabilitation)
3 | L: (2081S0010X) | C20227 | 2081S0010X | Sports Medicine |
2 | S: PlasticSurgeryProviderCodes (208200000X) | S20228 | 208200000X | Plastic Surgery |
3 | L: (2082S0099X) | C20229 | 2082S0099X | Plastic Surgery Within the Head and Neck | A plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgery are practiced, there are many additional procedures which interface with them. A subspecialty certificate was approved by the ABMS in 2000. ACGME Accredited Residency Program Requirements: None.
3 | L: (2082S0105X) | C20230 | 2082S0105X | Surgery of the Hand |
2 | S: PreventiveMedicineProviderCodes (208300000X) | S20231 | 208300000X | Preventive Medicine |
3 | L: (2083A0100X) | C20232 | 2083A0100X | Aerospace Medicine |
3 | L: (2083T0002X) | C20233 | 2083T0002X | Medical Toxicology |
3 | L: (2083X0100X) | C20234 | 2083X0100X | Occupational Medicine |
3 | L: (2083P0500X) | C20235 | 2083P0500X | Preventive Medicine/Occupational Environmental-Medicine |
3 | L: (2083P0901X) | C20236 | 2083P0901X | Public Health & General Preventive Medicine |
3 | L: (2083S0010X) | C20237 | 2083S0010X | Sports Medicine |
3 | L: (2083P0011X) | C20238 | 2083P0011X | Undersea and Hyperbaric Medicine |
2 | S: PsychiatryandNeurologyProviderCodes (208400000X) | S20239 | 208400000X | Psychiatry & Neurology |
3 | L: (2084A0401X) | C20240 | 2084A0401X | Addiction Medicine |
3 | L: (2084P0802X) | C20241 | 2084P0802X | Addiction Psychiatry |
3 | L: (2084P0804X) | C20242 | 2084P0804X | Child & Adolescent Psychiatry |
3 | L: (2084N0600X) | C20243 | 2084N0600X | Clinical Neurophysiology |
3 | L: (2084F0202X) | C20244 | 2084F0202X | Forensic Psychiatry |
3 | L: (2084P0805X) | C20245 | 2084P0805X | Geriatric Psychiatry |
3 | L: (2084P0005X) | C20246 | 2084P0005X | Neurodevelopmental Disabilities | Neurodevelopmental Disabilities is a subspecialty of Psychiatry and Neurology. A pediatrician or neurogist who specializes in the diagnosis and management of chronic conditions that affect the developing and mature nervous system such as cerebral palsy, mental retardation, and chronic behavioral syndromes, or neurologic conditions. A subspecialty certificate for NDN was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Ongoing early discussions regarding proposal.
3 | L: (2084N0400X) | C20247 | 2084N0400X | Neurology |
3 | L: (2084N0402X) | C20248 | 2084N0402X | Neurology with Special Qualifications in Child Neurology |
3 | L: (2084P2900X) | C20249 | 2084P2900X | Pain Medicine | A psychiatrist, neurologist, or child neurologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. A subspecialty certificate was approved by ABMS in 1998. ACGME Accredited Residency Program Requirements: None.
3 | L: (2084P0800X) | C20250 | 2084P0800X | Psychiatry |
3 | L: (2084S0010X) | C20251 | 2084S0010X | Sports Medicine |
3 | L: (2084V0102X) | C20252 | 2084V0102X | Vascular Neurology |
2 | S: RadiologyProviderCodes (208500000X) | S20253 | 208500000X | Radiology |
3 | L: (2085B0100X) | C20254 | 2085B0100X | Body Imaging |
3 | L: (2085R0202X) | C20255 | 2085R0202X | Diagnostic Radiology |
3 | L: (2085U0001X) | C20256 | 2085U0001X | Diagnostic Ultrasound |
3 | L: (2085N0700X) | C20257 | 2085N0700X | Neuroradiology |
3 | L: (2085N0904X) | C20258 | 2085N0904X | Nuclear Radiology |
3 | L: (2085P0229X) | C20259 | 2085P0229X | Pediatric Radiology |
3 | L: (2085R0001X) | C20260 | 2085R0001X | Radiation Oncology |
3 | L: (2085R0205X) | C20261 | 2085R0205X | Radiological Physics |
3 | L: (2085R0203X) | C20262 | 2085R0203X | Therapeutic Radiology |
3 | L: (2085R0204X) | C20263 | 2085R0204X | Vascular & Interventional Radiology |
2 | S: SurgeryProviderCodes (208600000X) | S20264 | 208600000X | Surgery |
3 | L: (2086S0120X) | C20265 | 2086S0120X | Pediatric Surgery |
3 | L: (2086S0122X) | C20266 | 2086S0122X | Plastic & Reconstructive Surgery |
3 | L: (2086S0105X) | C20267 | 2086S0105X | Surgery of the Hand |
3 | L: (2086S0102X) | C20268 | 2086S0102X | Surgical Critical Care |
3 | L: (2086X0206X) | C20269 | 2086X0206X | Surgical Oncology |
3 | L: (208G00000X) | C20272 | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
3 | L: (204F00000X) | C20273 | 204F00000X | Transplant Surgery |
3 | L: (2086S0127X) | C20270 | 2086S0127X | Trauma Surgery |
3 | L: (2086S0129X) | C20271 | 2086S0129X | Vascular Surgery |
2 | L: (208800000X) | C20274 | 208800000X | Urology |
1 | S: AmbulatoryHealthCareFacilitiesProviderCodes (260000000X) | S20678 | 260000000X | Ambulatory Health Care Facilities | A State-licensed facility that is not hospital-based where services are provided at a fixed specific location. An ambulatory care facility does not provide overnight accommodations.
2 | S: ClinicCenterProviderCodes (261Q00000X) | S20679 | 261Q00000X | Clinic/Center | A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/center" is irregularly defined, either including or excluding physician's offices and allied health professionals, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, public health). Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988; Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 185
3 | L: (261QM0855X) | C20806 | 261QM0855X | Adolescent and Children Mental Health | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
3 | L: (261QA0600X) | C20680 | 261QA0600X | Adult Day Care |
3 | L: (261QM0850X) | C20807 | 261QM0850X | Adult Mental Health | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
3 | L: (261QA0005X) | C20681 | 261QA0005X | Ambulatory Family Planning Facility | An abortion/family planning facility where services are provided at a fixed specific location. An Ambulatory Family Planning Facility does not provide overnight accommodations. The following procedures may be performed at an Ambulatory Family Planning Facility: abortions, laproscopy, hysterectomies, tubule ligation and other related procedures. Abortion is considered voluntary termination of pregnancy.
3 | L: (261QA0006X) | C20682 | 261QA0006X | Ambulatory Fertility Facility | A fertility facility, which may be licensed, registered, or certified in some states, that is not hospital-based, where services are provided at a fixed specific location. An Ambulatory Fertility Facility does not provide overnight accommodations. The following fertility procedures may be performed at an Ambulatory Fertility Facility: In Vitro Fertilization (IVF), Gamete Intrafallopian Transfer (GIFT), Embryo Transfer-Thaw (ET-T), Zygote Intrafallopian Transfer (ZIFT), Donor OOCYTE (DO)
3 | L: (261QA1903X) | C20683 | 261QA1903X | Ambulatory Surgical |
3 | L: (261QA0900X) | C20808 | 261QA0900X | Amputee | An entity, facility, or distinct part of a facility providing counseling, fitting, custom design, prescriptive, and training services related to congenital or postoperative absence of all or part of a limb or limbs.
3 | L: (261QA3000X) | C20809 | 261QA3000X | Augmentative Communication | An entity, facility, or distinct part of a facility staffed by audiology and/or speech professionals with special training in the evaluation of a patient's potential for use of an augmentative communication device, determination of the most appropriate device, adjustment and maintenance
3 | L: (261QB0400X) | C20684 | 261QB0400X | Birthing |
3 | L: (261QC1500X) | C20685 | 261QC1500X | Community Health |
3 | L: (261QC1800X) | C20686 | 261QC1800X | Corporate Health |
3 | L: (261QC0050X) | C20810 | 261QC0050X | Critical Access Hospital | An outpatient entity, facility, or distinct part of a facility within or affiliated with a Critical Access Hospital that provides access to primary care services for individuals in a small rural community and is Medicare certified.
3 | L: (261QD0000X) | C20687 | 261QD0000X | Dental |
3 | L: (261QD1600X) | C20811 | 261QD1600X | Developmental Disabilities | An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
3 | L: (261QE0002X) | C20688 | 261QE0002X | Emergency Care |
3 | L: (261QE0700X) | C20690 | 261QE0700X | End-Stage Renal Disease (ESRD) Treatment |
3 | L: (261QE0800X) | C20689 | 261QE0800X | Endoscopy |
3 | L: (261QF0050X) | C20812 | 261QF0050X | Family Planning, Non-Surgical | An entity, facility, or distinct part of a facility, or mobile unit providing non-surgical, family planning/reproductive services including physical examination, laboratory services such as PAP or pregnancy tests; pregnancy, pregnancy prevention/contraceptive, and nutritional counseling, and contraceptives or prescriptions for contraceptives.
3 | L: (261QF0400X) | C20691 | 261QF0400X | Federally Qualified Health Center (FQHC) |
3 | L: (261QG0250X) | C20813 | 261QG0250X | Genetics | An entity, facility, or distinct part of a facility providing analysis of family history, genetic laboratory testing and analysis, diagnosis of genetic trait, prognosis and options. Laboratory studies may be outsourced.
3 | L: (261QH0100X) | C20692 | 261QH0100X | Health |
3 | L: (261QH0700X) | C20814 | 261QH0700X | Hearing and Speech | An entity, facility, or distinct part of a facility providing diagnostic, treatment, prescriptive, and therapy services related to congenital and acquired conditions and diseases that affect hearing capacity and speech ability.
3 | L: (261QI0500X) | C20693 | 261QI0500X | Infusion Therapy |
3 | L: (261QL0400X) | C20694 | 261QL0400X | Lithotripsy |
3 | L: (261QM1200X) | C20695 | 261QM1200X | Magnetic Resonance Imaging (MRI) |
3 | L: (261QR0206X) | C20714 | 261QR0206X | Mammography |
3 | L: (261QM2500X) | C20815 | 261QM2500X | Medical Specialty | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
3 | L: (261QM3000X) | C20816 | 261QM3000X | Medically Fragile Infants and Children Day Care | An entity, facility, or distinct part of a facility specially equipped and staffed to provide care for medically fragile hildren with varied and complex care needs (e.g., enteral or parental feeding, ostomy care, respiratory/ventilator care, medications and therapies, etc.).
3 | L: (261QM0801X) | C20696 | 261QM0801X | Mental Health (Including Community Mental Health Center) |
3 | L: (261QM2800X) | C20817 | 261QM2800X | Methadone | An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services elated to individuals with drug addiction.
3 | L: (261QM1000X) | C20697 | 261QM1000X | Migrant Health |
3 | L: (261QM1100X) | C20698 | 261QM1100X | Military |
3 | L: (261QM1101X) | C20699 | 261QM1101X | Military Expanded Services |
3 | L: (261QM1102X) | C20700 | 261QM1102X | Military Operational Component |
3 | L: (261QR0208X) | C20715 | 261QR0208X | Mobile |
3 | L: (261QR0207X) | C20716 | 261QR0207X | Mobile Mammography |
3 | L: (261QM1300X) | C20701 | 261QM1300X | Multi-Specialty |
3 | L: (261QX0100X) | C20702 | 261QX0100X | Occupational Medicine |
3 | L: (261QX0200X) | C20818 | 261QX0200X | Oncology | An entity, facility, or distinct part of a facility providing diagnostic, treatment and prescriptive services related to cancerous conditions. Services include chemotherapy infusions and monitoring of implanted chemotherapeutic agents.
3 | L: (261QX0203X) | C20703 | 261QX0203X | Oncology, Radiation |
3 | L: (261QS0132X) | C20704 | 261QS0132X | Ophthalmologic Surgery |
3 | L: (261QS0112X) | C20705 | 261QS0112X | Oral and Maxillofacial Surgery | The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. Source: Council on Dental Education and Licensure, American Dental Association
3 | L: (261QP3300X) | C20706 | 261QP3300X | Pain |
3 | L: (261QP2000X) | C20707 | 261QP2000X | Physical Therapy |
3 | L: (261QP1100X) | C20708 | 261QP1100X | Podiatric |
3 | L: (261QP2300X) | C20709 | 261QP2300X | Primary Care |
3 | L: (261QP2400X) | C20710 | 261QP2400X | Prison Health |
3 | L: (261QP0904X) | C20711 | 261QP0904X | Public Health, Federal |
3 | L: (261QP0905X) | C20712 | 261QP0905X | Public Health, State or Local |
3 | L: (261QR0200X) | C20713 | 261QR0200X | Radiology |
3 | L: (261QR0800X) | C20717 | 261QR0800X | Recovery Care |
3 | L: (261QR0400X) | C20718 | 261QR0400X | Rehabilitation |
3 | L: (261QR0401X) | C20720 | 261QR0401X | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
3 | L: (261QR0405X) | C20721 | 261QR0405X | Rehabilitation, Substance Use Disorder |
3 | L: (261QR0404X) | C20719 | 261QR0404X | Rehabilitation: Cardiac Facilities |
3 | L: (261QR1100X) | C20722 | 261QR1100X | Research |
3 | L: (261QR1300X) | C20723 | 261QR1300X | Rural Health |
3 | L: (261QS1200X) | C20724 | 261QS1200X | Sleep Disorder Diagnostic |
3 | L: (261QS1000X) | C20725 | 261QS1000X | Student Health |
3 | L: (261QU0200X) | C20726 | 261QU0200X | Urgent Care |
3 | L: (261QV0200X) | C20727 | 261QV0200X | VA |
1 | S: BehavioralHealthandSocialServiceProvidersProviderCodes (100000000X) | S20275 | 100000000X | Behavioral Health and Social Service Providers | Broad classification aggregating providers who are trained and educated to perform services related to behavioral health, mental health, and counseling and may be licensed or practice within the scope or licensure or training.
2 | S: CounselorProviderCodes (101Y00000X) | S20276 | 101Y00000X | Counselor | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors.
3 | L: (101YA0400X) | C20277 | 101YA0400X | Addiction (Substance Use Disorder) |
3 | L: (101YM0800X) | C20278 | 101YM0800X | Mental Health |
3 | L: (101YP1600X) | C20279 | 101YP1600X | Pastoral |
3 | L: (101YP2500X) | C20280 | 101YP2500X | Professional |
3 | L: (101YS0200X) | C20281 | 101YS0200X | School |
2 | L: (106H00000X) | C20282 | 106H00000X | Marriage & Family Therapist | A mental health provider, e.g. social worker, psychologist, etc. who concentrates his/her practice on the social, emotional and psychological treatment of married couples and families.
2 | S: NeuropsychologistProviderCodes (103G00000X) | S20283 | 103G00000X | Neuropsychologist | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. Source: American Psychological Association, Washington, DC, 1997.
3 | L: (103GC0700X) | C20284 | 103GC0700X | Clinical |
2 | S: PsychologistProviderCodes (103T00000X) | S20285 | 103T00000X | Psychologist | An individual who specializes in psychological research, testing, and/or therapy. Psychology is the branch of science that deals with mental processes and behavior, composed of the following major fields: abnormal, clinical, comparative, counseling, developmental, educational, engineering, experimental, industrial, learning, motivation, perception, personality, physiological, psychometrics, school, and social psychology. Source: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 654.
3 | L: (103TA0400X) | C20286 | 103TA0400X | Addiction (Substance Use Disorder) |
3 | L: (103TA0700X) | C20287 | 103TA0700X | Adult Development & Aging |
3 | L: (103TB0200X) | C20288 | 103TB0200X | Behavioral |
3 | L: (103TC2200X) | C20289 | 103TC2200X | Child, Youth & Family |
3 | L: (103TC0700X) | C20290 | 103TC0700X | Clinical |
3 | L: (103TC1900X) | C20291 | 103TC1900X | Counseling |
3 | L: (103TE1000X) | C20292 | 103TE1000X | Educational |
3 | L: (103TE1100X) | C20293 | 103TE1100X | Exercise & Sports |
3 | L: (103TF0000X) | C20294 | 103TF0000X | Family |
3 | L: (103TF0200X) | C20295 | 103TF0200X | Forensic |
3 | L: (103TH0100X) | C20296 | 103TH0100X | Health |
3 | L: (103TM1700X) | C20297 | 103TM1700X | Men & Masculinity |
3 | L: (103TM1800X) | C20298 | 103TM1800X | Mental Retardation & Developmental Disabilities |
3 | L: (103TP0814X) | C20299 | 103TP0814X | Psychoanalysis | (1) A practitioner of psychoanalysis: methods of eliciting from patients their past emotional experiences and their role in influencing their current mental life, in order to discover the conflicts and mechanisms by which their pathologic mental state has been produced and to furnish hints for psychotherapeutic procedures, the method employs free association, recall and interpretation of dreams and interpretation of transference and resistance phenomena; (2) An individual who is educated with a doctor's degree in psychoanalysis or psychology, trained at an established psychoanalytic institute, and practices or adheres to the principles of psychoanalysis. Psychoanalysis is a form of psychotherapy and a system of investigation for determining and understanding mental processes, which was originally conceived by Sigmund Freud. Psychoanalysis involves the analysis and interpretation of dreams, resistances, and transferences, and uses free association and catharsis. Clinical practice requires licensure. Sources: (1) Dorlands Illustrated Medical Dictionary, 28th Edition, W.B. Saunders Company: Philadelphia, 1994, p. 1382; (2)American Psychological Association, Washington, DC, 1997, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.
3 | L: (103TP2700X) | C20300 | 103TP2700X | Psychotherapy |
3 | L: (103TP2701X) | C20301 | 103TP2701X | Psychotherapy, Group |
3 | L: (103TR0400X) | C20302 | 103TR0400X | Rehabilitation |
3 | L: (103TS0200X) | C20303 | 103TS0200X | School |
3 | L: (103TW0100X) | C20304 | 103TW0100X | Women |
2 | S: SocialWorkerProviderCodes (104100000X) | S20305 | 104100000X | Social Worker | A clinical social worker is a person who is qualified by a master of Social Work (M.S.W.) degree, licensed, certified or registered by the state as a social worker and practicing within the scope of that license. A social worker provides assistance and counseling to patients and their families and dealing with social, emotional and environmental problems.
3 | L: (1041C0700X) | C20306 | 1041C0700X | Clinical |
3 | L: (1041S0200X) | C20307 | 1041S0200X | School |
1 | S: ChiropracticProvidersProviderCodes (110000000X) | S20308 | 110000000X | Chiropractic Providers | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
2 | S: ChiropractorProviderCodes (111N00000X) | S20309 | 111N00000X | Chiropractor | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
3 | L: (111NI0900X) | C20310 | 111NI0900X | Internist |
3 | L: (111NN0400X) | C20311 | 111NN0400X | Neurology |
3 | L: (111NN1001X) | C20312 | 111NN1001X | Nutrition |
3 | L: (111NX0100X) | C20313 | 111NX0100X | Occupational Medicine |
3 | L: (111NX0800X) | C20314 | 111NX0800X | Orthopedic |
3 | L: (111NR0200X) | C20315 | 111NR0200X | Radiology |
3 | L: (111NS0005X) | C20316 | 111NS0005X | Sports Physician |
3 | L: (111NT0100X) | C20317 | 111NT0100X | Thermography |
1 | S: DentalProvidersProviderCodes (120000000X) | S20318 | 120000000X | Dental Providers | Broad category to identify practitioners who render services related the practice of dentistry. Dentistry is defined as the evaluation, diagnosis, prevention and/or treatment (nonsurgical, surgical or related procedures) of diseases, disorders and/or conditions of the oral cavity, maxillofacial area and/or the adjacent and associated structures and their impact on the human body; provided by a dentist, within the scope of his/her education, training and experience, in accordance with the ethics of the profession and applicable law.
2 | L: (126800000X) | C20319 | 126800000X | Dental Assistant | An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. The scope of the patient care functions that may be legally delegated to the dental assistant varies based on the needs of the dentist the educational preparation of the dental assistant and state dental practice acts and regulations. Patient care services are provided under the supervision of a dentist. To avoid misleading the public, no occupational title other than dental assistant should be used to describe this dental auxiliary. Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association
2 | L: (124Q00000X) | C20320 | 124Q00000X | Dental Hygienist | An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association.
2 | L: (126900000X) | C20321 | 126900000X | Dental Laboratory Technician | An individual who has the skill and knowledge in the fabrication of dental appliances, prostheses and devices in accordance with a dentist's laboratory work authorization. To avoid misleading the public, no occupational title other than dental laboratory technician or certified dental technician (when appropriate) should be used to describe this auxiliary. Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association.
2 | S: DentistProviderCodes (122300000X) | S20322 | 122300000X | Dentist | A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. Source: Council on Dental Education and Licensure, American Dental Association
3 | L: (1223D0001X) | C20323 | 1223D0001X | Dental Public Health | The science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis. Source: Council on Dental Education and Licensure, American Dental Association
3 | L: (1223E0200X) | C20324 | 1223E0200X | Endodontics | The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. Source: Council on Dental Education and Licensure, American Dental Association
3 | L: (1223G0001X) | C20325 | 1223G0001X | General Practice | A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. Source: Academy of General Dentistry
3 | L: (1223P0106X) | C20326 | 1223P0106X | Oral and Maxillofacial Pathology | The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. Source: Council on Dental Education and Licensure, American Dental Association
3 | L: (1223X0008X) | C20327 | 1223X0008X | Oral and Maxillofacial Radiology | The specialty of dentistry and discipline of radiology concerned with the production and interpretation of images and data produced by all modalities of radiant energy that are used for the diagnosis and management of diseases, disorders and conditions of the oral and maxillofacial region. Source: Council on Dental Education and Licensure, American Dental Association
3 | L: (1223S0112X) | C20328 | 1223S0112X | Oral and Maxillofacial Surgery | The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. Source: Council on Dental Education and Licensure, American Dental Association
3 | L: (1223X0400X) | C20329 | 1223X0400X | Orthodontics and Dentofacial Orthopedics | That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. 1-30-2003
3 | L: (1223P0221X) | C20330 | 1223P0221X | Pediatric Dentistry | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. Source: Council on Dental Education and Licensure, American Dental Association
3 | L: (1223P0300X) | C20331 | 1223P0300X | Periodontics | That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. Source: Council on Dental Education and Licensure, American Dental Association
3 | L: (1223P0700X) | C20332 | 1223P0700X | Prosthodontics | That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. Source: Council on Dental Education and Licensure, American Dental Association
2 | L: (122400000X) | C20333 | 122400000X | Denturist |
1 | S: DietaryandNutritionalServiceProvidersProviderCodes (130000000X) | S20334 | 130000000X | Dietary and Nutritional Service Providers | Broad category defining practitioners who help prevent and treat illness by promoting healthy eating habits, scientifically evaluating diets and suggesting modifications. They may also assess the nutritional needs of patients, develop and implement nutritional care plans.
2 | L: (132700000X) | C20335 | 132700000X | Dietary Manager | A dietary manager is a trained food services professional who is charged with maintaining cost/profit objectives, purchasing foods and services for the department and supervising staff.. Dietary managers are trained to understand the basic nutritional needs of clients and work in partnership with dietitians, who offer specialized nutritional expertise. The CDM certified dietary manager designation is an advanced professional credential awarded to dietary managers who have completed specific course work, have passed the national credentialing exams (including a sanitation and safety exam) and have applied for certification.
2 | L: (136A00000X) | C20336 | 136A00000X | Dietetic Technician, Registered | A person trained in food and nutrition who is an integral part of health care and foodservice management teams. A dietetic technician, registered (DTR) has successfully completed at least a two-year associate's degree at a US regionally accredited college or university; a dietetic technician program approved by The American Dietetic Association, including 450 hours of supervised practice experience; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. Source: The American Dietetic Association. Becoming a Dietetic Technician, Registered -- a food and nutrition practitioner. Chicago, IL: The American dietetic association, July 1997.
2 | S: DietitianRegisteredProviderCodes (133V00000X) | S20337 | 133V00000X | Dietitian, Registered | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor's degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. Source: The American Dietetic Association. Becoming a Registered Dietitian - a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997.
3 | L: (133VN1006X) | C20338 | 133VN1006X | Nutrition, Metabolic |
3 | L: (133VN1004X) | C20339 | 133VN1004X | Nutrition, Pediatric |
3 | L: (133VN1005X) | C20340 | 133VN1005X | Nutrition, Renal |
2 | S: NutritionistProviderCodes (133N00000X) | S20341 | 133N00000X | Nutritionist | A specialist in adapting and applying food and nutrient knowledge to the solution of food and nutritional problems, the control of disease, and the promotion of health. Nutritionists perform research, instruct groups and individuals about nutritional requirements, and assist people in developing meal patterns that meet their nutritional needs; (2) A nutritionist is someone who has completed undergraduate and/or graduate training in the discipline of nutrition without necessarily meeting the academic and experience requirements to qualify for the Registered Dietitian designation. Source: (1) Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.
3 | L: (133NN1002X) | C20342 | 133NN1002X | Nutrition, Education |
1 | S: EmergencyMedicalServiceProvidersProviderCodes (140000000X) | S20343 | 140000000X | Emergency Medical Service Providers | Broad category for individuals who complete additional training and education in the area of pre-hospital emergency services and are licensed and/or practice within the scope of that training.
2 | L: (146N00000X) | C20344 | 146N00000X | Emergency Medical Technician, Basic | A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards. Sources: Tabers Medical Dictionary and Florida EMS Clearing House.
2 | L: (146M00000X) | C20345 | 146M00000X | Emergency Medical Technician, Intermediate | An Intermediate EMT is an individual trained and certified to perform intermediate life support treatment in medical emergencies based on individual state boards. Sources: Tabers Medical Dictionary and Florida EMS Clearing House.
2 | L: (146L00000X) | C20346 | 146L00000X | Emergency Medical Technician, Paramedic | An EMT, Paramedic is an individual trained and certified to perform advanced life support (ALS) in medical emergencies based on individual state boards. Sources: Tabers Medical Dictionary and Florida EMS Clearing House.
2 | L: (146D00000X) | C20347 | 146D00000X | Personal Emergency Response Attendant | Individuals that are specially trained to assist patients living at home with urgent/emergent situations. These individuals must be able to perform CPR and basic first aid and have sufficient counseling skills to allay fears and assist in working through processes necessary to resolve the crisis. Functions may include transportation to various facilities and businesses, contacting agencies to initiate remediation service or providing reassurance.
1 | S: EyeandVisionServiceProvidersProviderCodes (150000000X) | S20348 | 150000000X | Eye and Vision Service Providers | Broad category grouping individuals who renders services related to the human eye and visual systems, but are not an allopathic or osteopathic physicians.
2 | S: OptometristProviderCodes (152W00000X) | S20349 | 152W00000X | Optometrist | An optometrist is a person qualified by a Doctor of Optometry (O.D. / degree, licensed by the state and practicing within the scope of that license. Optometrists examine the eyes and related structures to determine the presence of any abnormality and prescribe and adapt lenses or optical aids. They use drugs for diagnosis in all states and for treatment in some states. They do not perform surgery.
3 | L: (152WC0802X) | C20350 | 152WC0802X | Corneal and Contact Management |
3 | L: (152WL0500X) | C20351 | 152WL0500X | Low Vision Rehabilitation |
3 | L: (152WX0102X) | C20352 | 152WX0102X | Occupational Vision |
3 | L: (152WP0200X) | C20353 | 152WP0200X | Pediatrics |
3 | L: (152WS0006X) | C20354 | 152WS0006X | Sports Vision |
3 | L: (152WV0400X) | C20355 | 152WV0400X | Vision Therapy |
2 | S: TechnicianTechnologistProviderCodes (156F00000X) | S20356 | 156F00000X | Technician/Technologist | A broad category grouping different kinds of technologists and technicians. See individual definitions.
3 | L: (156FC0800X) | C20357 | 156FC0800X | Contact Lens |
3 | L: (156FC0801X) | C20358 | 156FC0801X | Contact Lens Fitter |
3 | L: (156FX1700X) | C20359 | 156FX1700X | Ocularist |
3 | L: (156FX1100X) | C20360 | 156FX1100X | Ophthalmic |
3 | L: (156FX1101X) | C20361 | 156FX1101X | Ophthalmic Assistant |
3 | L: (156FX1800X) | C20362 | 156FX1800X | Optician |
3 | L: (156FX1201X) | C20363 | 156FX1201X | Optometric Assistant |
3 | L: (156FX1202X) | C20364 | 156FX1202X | Optometric Technician |
3 | L: (156FX1900X) | C20365 | 156FX1900X | Orthoptist |
1 | S: GroupProviderCodes (190000000X) | S20800 | 190000000X | Group | A business entity under which one or more individuals practice. A group does not require multiple professional providers. A single provider group is a valid group and would be identified by the business entity name, for instance - John Doe, PC.
2 | L: (193200000X) | C20801 | 193200000X | Multi-Specialty | A business group of one or more individual practitioners, who practice with different areas of specialization.
2 | L: (193400000X) | C20802 | 193400000X | Single Specialty | A business group of one or more individual practitioners, all of who practice with the same area of specialization.
1 | S: HospitalUnitsProviderCodes (270000000X) | S20728 | 270000000X | Hospital Units | A distinct part of a general acute care hospital. The distinctness of a unit is determined by characteristics such as the following: the unit has admission and discharge records that are separately identified from those of the hospital; the hospital has policies specifying that necessary clinical information is transferred to the unit when a patient of the hospital is transferred to the unit; the hospital's utilization review plan includes separate standards for the type of care offered in the unit; the beds assigned to the unit are physically separate from beds not included in the unit; the unit is treated as a separate cost center for cost reporting, funding and apportionment purposes.
2 | L: (275N00000X) | C20729 | 275N00000X | Medicare Defined Swing Bed Unit | A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. Source: Code of Federal Regulations #42, Section 482.66.
2 | L: (273R00000X) | C20730 | 273R00000X | Psychiatric Unit | In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27.
2 | L: (273Y00000X) | C20731 | 273Y00000X | Rehabilitation Unit | In general, a distinct unit of a general acute care hospital that provides care encompassing a comprehensive array of restoration services for the disabled and all support services necessary to help patients attain their maximum functional capacity. Source: AHA Annual Survey p. A10 1996 AHA Guide. For Medicare, a distinct part of a general acute care hospital providing inpatient rehabilitation services that meets the following requirements. Rehabilitation Units have in effect a preadmission screening procedure under which each prospective patient's condition and medical history are reviewed to determine whether the patient is likely to benefit significantly from an intensive inpatient program or assessment; ensure that the patients receive close medical supervision and furnish, through the use of qualified personnel, rehabilitation nursing, physical therapy and occupational therapy, plus, as needed, speech therapy, social services or psychological services and orthotic and prosthetic services; have a plan of treatment for each inpatient that is established, reviewed, and revised as needed by a physician in consultation with other professional personnel who provide services to the patient; use a coordinated multidisciplinary team approach in the rehabilitation of each inpatient, as documented by periodic clinical entries made in the patient's medical record to note the patient's status in relationship to goal attainment , and that team conferences are held at least every two weeks to determine the appropriateness of treatment; have a director of rehabilitation who provides services to the unit and its inpatients for at least 20 hours a week, is a doctor of medicine or osteopathy, is licensed under State law to practice medicine or surgery, and has had, after completing a one-year hospital internship at least two years of training or experience in the medical management of inpatients requiring rehabilitation services. Source: Code of Federal Regulations #42, Section 412.29.
2 | L: (276400000X) | C20732 | 276400000X | Rehabilitation, Substance Use Disorder Unit | A distinct part of a hospital that provides medically monitored, interdisciplinary addiction-focused treatment to patients/clients who have psychoactive substance use disorders (commonly referred to as alcohol and drug abuse or substance abuse.) Source: Department of Defense Regulation 6010.8-R, Chapter 6.
1 | S: HospitalsProviderCodes (280000000X) | S20733 | 280000000X | Hospitals | A health care organization that has a governing body, an organized medical staff and professional staff and inpatient facilities and provides medical nursing and related services for ill and injured patients 24 hrs per day, seven days per week. For licensing purposes, each state has its own definition of hospital.
2 | L: (287300000X) | C20734 | 287300000X | Christian Science Sanitarium(hospital services) | A Christian Science sanitarium operated, or listed and certified, by The First Church of Christ, Scientist, Boston, Massachusetts, furnishing inpatient hospital care services. Source: Paraphrased from Section 1861(e) of the Social Security Act.
2 | S: ChronicDiseaseHospitalProviderCodes (281P00000X) | S20735 | 281P00000X | Chronic Disease Hospital | (1) A hospital including a physical plant and personnel that provides multidisciplinary diagnosis and treatment for diseases that have one or more of the following characteristics: is permanent; leaves residual disability; is caused by nonreversible pathological alteration; requires special training of the patient for rehabilitation; and/or may be expected to require a long period of supervision or care. In addition, patients require the safety, security, and shelter of these specialized inpatient or partial hospitalization settings. (2) A hospital that provides medical and skilled nursing services to patients with long-term illnesses who are not in an acute phase but who require an intensity of services not available in nursing homes. Source: (1) Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.
3 | L: (281PC2000X) | C20736 | 281PC2000X | Children |
2 | S: GeneralAcuteCareHospitalProviderCodes (282N00000X) | S20737 | 282N00000X | General Acute Care Hospital | An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.
3 | L: (282NC2000X) | C20738 | 282NC2000X | Children |
3 | L: (282NC0060X) | C20819 | 282NC0060X | Critical Access |
3 | L: (282NR1301X) | C20739 | 282NR1301X | Rural |
3 | L: (282NW0100X) | C20740 | 282NW0100X | Women |
2 | S: MilitaryHospitalProviderCodes (286500000X) | S20741 | 286500000X | Military Hospital | A health care facility operated by the Department of Defense.
3 | L: (2865C1500X) | C20742 | 2865C1500X | Community Health |
3 | L: (2865M2000X) | C20743 | 2865M2000X | Medical Center |
3 | L: (2865X1600X) | C20744 | 2865X1600X | Operational Component Facility |
2 | L: (283Q00000X) | C20745 | 283Q00000X | Psychiatric Hospital | An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.
2 | S: RehabilitationHospitalProviderCodes (283X00000X) | S20746 | 283X00000X | Rehabilitation Hospital | A hospital or facility that provides health-related, social and/or vocational services to disabled persons to help them attain their maximum functional capacity. Source: Joint Commission on Accreditation of Healthcare Organizations, Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Oakbrook Terrace, IL: 1994, p. 323
3 | L: (283XC2000X) | C20747 | 283XC2000X | Children |
2 | L: (284300000X) | C20748 | 284300000X | Special Hospital | A designation by the AHA of a hospital whose primary function of the institution is to provide diagnostic and treatment services for patients who have specified medical conditions, both surgical and nonsurgical. Source: AHA Guide, Registration section, p. A5.
1 | S: LaboratoriesProviderCodes (290000000X) | S20749 | 290000000X | Laboratories | A room or building equipped for scientific experimentation, research, testing, or clinical studies of materials, fluids, or tissues obtained from patients.
2 | L: (291U00000X) | C20750 | 291U00000X | Clinical Medical Laboratory | (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186.
2 | L: (292200000X) | C20751 | 292200000X | Dental Laboratory | A commercial laboratory specializing in the construction of dental appliances that conform to a dentist's specifications including the construction of dentures (complete or partial), orthodontic appliances, bridgework, crowns, and inlays. Source: Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 1245.
2 | L: (293D00000X) | C20752 | 293D00000X | Physiological Laboratory, (Independent Physiological Lab) | A laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5.
1 | S: ManagedCareOrganizationsProviderCodes (300000000X) | S20753 | 300000000X | Managed Care Organizations |
2 | L: (302F00000X) | C20754 | 302F00000X | Exclusive Provider Organization | (1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations. Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 15; (2) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 58; (3) Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.
2 | L: (302R00000X) | C20755 | 302R00000X | Health Maintenance Organization | (1) A form of health insurance in which its members prepay a premium for the HMO's health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model. Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 20; (2) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 58
2 | L: (305S00000X) | C20756 | 305S00000X | Point of Service | This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 62
2 | L: (305R00000X) | C20757 | 305R00000X | Preferred Provider Organization | A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62
1 | S: NursingServiceProvidersProviderCodes (160000000X) | S20366 | 160000000X | Nursing Service Providers | Providers who are trained and educated to perform services in health promotion, disease prevention, acute and chronic care, and restoration of health, and health maintenance across the life span.
2 | L: (164W00000X) | C20367 | 164W00000X | Licensed Practical Nurse | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.
2 | L: (167G00000X) | C20368 | 167G00000X | Licensed Psychiatric Technician | An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities.
2 | L: (164X00000X) | C20369 | 164X00000X | Licensed Vocational Nurse | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. [An alternate term for licensed practical nurse arising from difference in occupational titles between states and post-high school training programs and institutions.] Requirements for education, experience, licensure, and job responsibilities vary among the states. Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.
2 | S: RegisteredNurseProviderCodes (163W00000X) | S20370 | 163W00000X | Registered Nurse | (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span. Sources: (2) American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.
3 | L: (163WA0400X) | C20371 | 163WA0400X | Addiction (Substance Use Disorder) |
3 | L: (163WA2000X) | C20372 | 163WA2000X | Administrator |
3 | L: (163WP2201X) | C20373 | 163WP2201X | Ambulatory Care |
3 | L: (163WC3500X) | C20374 | 163WC3500X | Cardiac Rehabilitation |
3 | L: (163WC0400X) | C20375 | 163WC0400X | Case Management |
3 | L: (163WC1400X) | C20376 | 163WC1400X | College Health |
3 | L: (163WC1500X) | C20377 | 163WC1500X | Community Health |
3 | L: (163WC2100X) | C20378 | 163WC2100X | Continence Care |
3 | L: (163WC1600X) | C20379 | 163WC1600X | Continuing Education/Staff Development |
3 | L: (163WC0200X) | C20380 | 163WC0200X | Critical Care Medicine |
3 | L: (163WD0400X) | C20381 | 163WD0400X | Diabetes Educator |
3 | L: (163WD1100X) | C20382 | 163WD1100X | Dialysis, Peritoneal |
3 | L: (163WE0003X) | C20383 | 163WE0003X | Emergency |
3 | L: (163WE0900X) | C20384 | 163WE0900X | Enterostomal Therapy |
3 | L: (163WF0300X) | C20385 | 163WF0300X | Flight |
3 | L: (163WG0100X) | C20386 | 163WG0100X | Gastroenterology |
3 | L: (163WG0000X) | C20387 | 163WG0000X | General Practice |
3 | L: (163WG0600X) | C20388 | 163WG0600X | Gerontology |
3 | L: (163WH0500X) | C20389 | 163WH0500X | Hemodialysis |
3 | L: (163WH0200X) | C20390 | 163WH0200X | Home Health |
3 | L: (163WH1000X) | C20391 | 163WH1000X | Hospice |
3 | L: (163WI0600X) | C20392 | 163WI0600X | Infection Control |
3 | L: (163WI0500X) | C20393 | 163WI0500X | Infusion Therapy |
3 | L: (163WL0100X) | C20394 | 163WL0100X | Lactation Consultant |
3 | L: (163WM0102X) | C20395 | 163WM0102X | Maternal Newborn |
3 | L: (163WM0705X) | C20396 | 163WM0705X | Medical-Surgical |
3 | L: (163WN0002X) | C20397 | 163WN0002X | Neonatal Intensive Care |
3 | L: (163WN0003X) | C20398 | 163WN0003X | Neonatal, Low-Risk |
3 | L: (163WN0300X) | C20399 | 163WN0300X | Nephrology |
3 | L: (163WN0800X) | C20400 | 163WN0800X | Neuroscience |
3 | L: (163WM1400X) | C20401 | 163WM1400X | Nurse Massage Therapist (NMT) |
3 | L: (163WN1003X) | C20402 | 163WN1003X | Nutrition Support |
3 | L: (163WX0002X) | C20403 | 163WX0002X | Obstetric, High-Risk |
3 | L: (163WX0003X) | C20404 | 163WX0003X | Obstetric, Inpatient |
3 | L: (163WX0106X) | C20405 | 163WX0106X | Occupational Health |
3 | L: (163WX0200X) | C20406 | 163WX0200X | Oncology |
3 | L: (163WX1100X) | C20407 | 163WX1100X | Ophthalmic |
3 | L: (163WX0800X) | C20408 | 163WX0800X | Orthopedic |
3 | L: (163WX1500X) | C20409 | 163WX1500X | Ostomy Care |
3 | L: (163WX0601X) | C20410 | 163WX0601X | Otorhinolaryngology & Head-Neck |
3 | L: (163WP0000X) | C20411 | 163WP0000X | Pain Management |
3 | L: (163WP0218X) | C20412 | 163WP0218X | Pediatric Oncology |
3 | L: (163WP0200X) | C20413 | 163WP0200X | Pediatrics |
3 | L: (163WP1700X) | C20414 | 163WP1700X | Perinatal |
3 | L: (163WS0121X) | C20415 | 163WS0121X | Plastic Surgery |
3 | L: (163WP0808X) | C20416 | 163WP0808X | Psychiatric/Mental Health |
3 | L: (163WP0809X) | C20417 | 163WP0809X | Psychiatric/Mental Health, Adult |
3 | L: (163WP0807X) | C20418 | 163WP0807X | Psychiatric/Mental Health, Child & Adolescent |
3 | L: (163WR0400X) | C20419 | 163WR0400X | Rehabilitation |
3 | L: (163WR1000X) | C20420 | 163WR1000X | Reproductive Endocrinology/Infertility |
3 | L: (163WS0200X) | C20421 | 163WS0200X | School |
3 | L: (163WU0100X) | C20422 | 163WU0100X | Urology |
3 | L: (163WW0101X) | C20423 | 163WW0101X | Women's Health Care, Ambulatory |
3 | L: (163WW0000X) | C20424 | 163WW0000X | Wound Care |
1 | S: NursingServiceRelatedProvidersProviderCodes (370000000X) | S20425 | 370000000X | Nursing Service Related Providers | Providers who are trained and educated to perform and administer services related to health promotion, disease prevention, acute and chronic care, spiritual guidance and comfort for healing and health, restoration of health and health maintenance across the life span.
2 | L: (372600000X) | C20803 | 372600000X | Adult Companion | An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care.
2 | L: (372500000X) | C20804 | 372500000X | Chore Provider | An individual who provides home maintenance services required to sustain a safe, sanitary living environment for individuals who because of age or disabilities is unable to perform the activities. These services include heavy household chores such as washing floors, windows, and walls; tacking down loose rugs and tiles; and moving heavy items of furniture in order to provide safe access and egress.
2 | L: (374T00000X) | C20426 | 374T00000X | Christian Science Practitioner/Nurse | A practitioner listed and certified by The First Church of Christ, Scientist, Boston, Massachusetts. Source: Paraphrased from Code of Federal Regulations #42, Section 440.170.
2 | L: (373H00000X) | C20427 | 373H00000X | Day Traning/Habilitation Specialist | Individuals experienced or trained in working with developmentally disabled individuals who need assistance in acquiring and maintaining life skills that enable them to cope more effectively with the demands of independent living.
2 | L: (374U00000X) | C20428 | 374U00000X | Home Health Aide | A person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes. Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.
2 | L: (376J00000X) | C20429 | 376J00000X | Homemaker | An individual who provides general household activities such as meal preparation, laundry, and light housekeeping, when the individual regularly responsible for these activities is temporarily absent or unable to provide for himself. Homemakers must meet the state defined training standards.
2 | L: (376K00000X) | C20430 | 376K00000X | Nurse's Aide | (1) An unlicensed individual who is trained to function in an assistive role to the licensed nurse in the provision of patient/client activities as delegated by the nurse; (2) An individual trained (either on-the-job or through a formal course generally of less than one year) and experienced in performing patient or client-care nursing tasks that do not require the skills of a specialist, technician, or professional. Examples of tasks performed by nurses aides include changing clothes, diapers, and beds; assisting patients to perform exercises or personal hygiene tasks, and supporting communication or social interaction. Specific education and credentials are not required for this work. Source: (1) American Nurses Association, Registered Professional Nurses and Unlicensed Personnel, 2nd ed., 1996; (2) Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.
2 | L: (376G00000X) | C20431 | 376G00000X | Nursing Home Administrator | An individual, often licensed by the state, who is responsible for the management of a nursing home. Source: Lexikon: Dictionary of Health Care Terms, Organizations, and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL, 1994, p. 552.
2 | S: TechnicianProviderCodes (374700000X) | S20432 | 374700000X | Technician | (1) A person with specialized training in a narrow field of expertise whose occupation requires training and is skilled in specific technical processes and procedures. (2) An individual having special skill or practical knowledge in an area, such as operation and maintenance of equipment or performance of laboratory procedures involving biochemical analyses. Special technical qualifications are normally required, though an increasing number or technicians also possess university degrees in science, and occasionally doctorate degrees. The distinction between technician and technologist in the health care field is not always clear. Sources: (1) Rhea, Ott, and Shafritz, The Facts on File Dictionary of Health Care Management, New York: Facts on File Publications, 1988; Dorland's Illustrated Medical Dictionary, 26th Edition, Philadelphia: W.B. Saunders Company, 1981 and Webster's II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1984. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 776.
3 | L: (3747A0650X) | C20805 | 3747A0650X | Attendant Care Provider | An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent ermitted by state law.
3 | L: (3747P1801X) | C20433 | 3747P1801X | Personal Care Attendant | An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards.
1 | S: NursingandCustodialCareFacilitiesProviderCodes (310000000X) | S20758 | 310000000X | Nursing and Custodial Care Facilities | Broad category identifying licensed facilities with inpatient beds specializing in nursing and custodial care.
2 | L: (311500000X) | C20759 | 311500000X | Alzheimer Center /Dementia Center/Dementia Special Care Unit | A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer's Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations.
2 | S: AssistedLivingFacilityProviderCodes (310400000X) | S20820 | 310400000X | Assisted Living Facility | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
3 | L: (3104A0630X) | C20821 | 3104A0630X | Assisted Living, Behavioral Disturbances | A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors.
3 | L: (3104A0625X) | C20822 | 3104A0625X | Assisted Living, Mental Illness | A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies.
2 | L: (317400000X) | C20760 | 317400000X | Christian Science Facility (skilled nursing services) | A Christian Science sanitarium operated, or listed and certified, by The First Church of Christ, Scientist, Boston, Massachusetts, furnishing extended care services. Source: Paraphrased from Section 1861(y) (1) of the Social Security Act.
2 | S: CustodialCareFacilityProviderCodes (311Z00000X) | S20761 | 311Z00000X | Custodial Care Facility | A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. Source: Paraphrased from Section 3159 A3 of the Medicare Intermediary Manual.
3 | L: (311ZA0620X) | C20823 | 311ZA0620X | Adult Care Home | A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
2 | L: (315D00000X) | C20762 | 315D00000X | Hospice, Inpatient | A provider organization, or distinct part of the organization, which renders an interdisciplinary program providing palliative care, chiefly medical relief of pain and supporting services, which addresses the emotional, social, financial, and legal needs of terminally ill patients and their families where an institutional care environment is required for the patient. Source: AHA Guide, American Hospital Association.
2 | L: (315P00000X) | C20763 | 315P00000X | Intermediate Care Facility, Mentally Retarded | (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c).
2 | L: (310500000X) | C20824 | 310500000X | Intermediate Care, Mental Illness | A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness.
2 | L: (313M00000X) | C20764 | 313M00000X | Nursing Facility/Intermediate Care Facility | An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. Source: Paraphrased from Section 1919 (a) of the Social Security Act.
2 | S: SkilledNursingFacilityProviderCodes (314000000X) | S20765 | 314000000X | Skilled Nursing Facility | (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey.
3 | L: (3140N1450X) | C20825 | 3140N1450X | Nursing Care, Pediatric | A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment.
1 | S: OtherServiceProvidersProviderCodes (170000000X) | S20434 | 170000000X | Other Service Providers | Providers not otherwise classified, who perform or administer services in or related to the delivery or research of health care services, disease, and restoration of health. An individual provider who is not represented in one of the identified categories but whose data may be needed for clinical, operational or administrative processes.
2 | L: (171100000X) | C20435 | 171100000X | Acupuncturist | An acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia.
2 | S: ContractorProviderCodes (171W00000X) | S20436 | 171W00000X | Contractor | A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308
3 | L: (171WH0202X) | C20437 | 171WH0202X | Home Modifications |
3 | L: (171WV0202X) | C20438 | 171WV0202X | Vehicle Modifications | A contractor who makes modifications to private vehicles to accommodate a health condition.
2 | L: (172A00000X) | C20439 | 172A00000X | Driver | A person employed to operate a motor vehicle as a carrier of persons or property.
2 | L: (176P00000X) | C20440 | 176P00000X | Funeral Director | A person, usually an embalmer, whose business is to arrange for the burial or cremation of the dead and to assist at the funeral rites. Source: Joint Commission on Accreditation of Healthcare Organizations, Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Oakbrook Terrace, IL: 1994, p. 323
2 | L: (175L00000X) | C20441 | 175L00000X | Homeopath | A provider who is educated and trained in a system of therapeutics in which diseases are treated by drugs which are capable of producing in healthy persons symptoms like those of the disease to be treated. Treatment requires administering a drug in minute doses. Source: Dorland's Illustrated Medical Dictionary. 26th edition. Philadelphia: W.B. Saunders Company, 1981.
2 | L: (173000000X) | C20442 | 173000000X | Legal Medicine | The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections. Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.
2 | L: (177F00000X) | C20443 | 177F00000X | Lodging | A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
2 | L: (176B00000X) | C20444 | 176B00000X | Midwife, Certified | A provider educated in the independent management of women's health and focusing particularly on pregnancy, childbirth, the post-partum period, care of the newborn, family planning and gynecological needs of women and primary care of women. Certification requires education at the post-secondary level in midwifery and health services. Source: The American College of Nurse-Midwives, Position Statements, www.midwife.org/prof/defcnm.htm
2 | L: (175M00000X) | C20445 | 175M00000X | Midwife, Lay | A person qualified by experience and limited specialized training to provide obstetric and neo-natal care in the management of women having normal pregnancy, labor and childbirth. The lay midwife is licensed in some states.
2 | L: (175F00000X) | C20446 | 175F00000X | Naturopath | An individual who practices naturopathy, a system of therapeutics in which neither surgical nor medicinal agents are used, dependence being placed only on natural (nonmedicinal) forces.
2 | L: (170100000X) | C20447 | 170100000X | Ph.D. Medical Genetics | A medical geneticist works in association with a medical specialist, is affiliated with a clinical genetics program, and serves as a consultant to medical and dental specialists. A general certificate was first issued by ABMS in 1982. ACGME Accredited Residency Program Requirements: None.
2 | S: SpecialistProviderCodes (174400000X) | S20448 | 174400000X | Specialist | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Source: Expanded from Webster's II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974.
3 | L: (1744G0900X) | C20449 | 1744G0900X | Graphics Designer |
3 | L: (1744P3200X) | C20450 | 1744P3200X | Prosthetics Case Management |
3 | L: (1744R1103X) | C20451 | 1744R1103X | Research Data Abstracter/Coder |
3 | L: (1744R1102X) | C20452 | 1744R1102X | Research Study |
3 | S: VeterinarianProviderCodes (174M00000X) | S20453 | 174M00000X | Veterinarian | A doctor of veterinary medicine, trained and authorized to practice veterinarian medicine and surgery. Source: Dorland's Illustrated Medical Dictionary. 28th edition. Philadelphia: W.B. Saunders Company, 1994, p. 1823
4 | L: (174MM1900X) | C20454 | 174MM1900X | Medical Research |
1 | S: PharmacyServiceProvidersProviderCodes (180000000X) | S20455 | 180000000X | Pharmacy Service Providers | A broad category grouping providers who render services relating to the preparation and dispensing of drugs.
2 | S: PharmacistProviderCodes (183500000X) | S20456 | 183500000X | Pharmacist | An individual who is licensed to prepare and sell or dispense drugs and compounds and to make up prescriptions. Source: Dorland's Illustrated Medical Dictionary, 26th Edition, Philadelphia: W.. Saunders Company, 1981.
3 | L: (1835G0000X) | C20457 | 1835G0000X | General Practice |
3 | L: (1835N0905X) | C20458 | 1835N0905X | Nuclear Pharmacy |
3 | L: (1835N1003X) | C20459 | 1835N1003X | Nutrition Support |
3 | L: (1835P1200X) | C20460 | 1835P1200X | Pharmacotherapy |
3 | L: (1835P1300X) | C20461 | 1835P1300X | Psychopharmacy |
2 | L: (183700000X) | C20462 | 183700000X | Pharmacy Technician |
1 | S: PhysicianAssistantsandAdvancedPracticeNursingProvidersProviderCodes (360000000X) | S20463 | 360000000X | Physician Assistants and Advanced Practice Nursing Providers | A broad grouping of providers who are: 1) trained, educated, and certified to perform basic medical and minor surgical services (or to assist the physician in performance of more complex services) under general physician supervision; and 2) trained, educated at a post-graduate level, and certified to perform autonomous and specialized roles as nurse practitioners, midwives, nurse anesthetists, or clinical nurse specialists.
2 | L: (367H00000X) | C20464 | 367H00000X | Anesthesiologist Assistant | An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.
2 | S: ClinicalNurseSpecialistProviderCodes (364S00000X) | S20465 | 364S00000X | Clinical Nurse Specialist | A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration. Sources: American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue and The Interagency Conference on Nursing Statistics.
3 | L: (364SA2100X) | C20466 | 364SA2100X | Acute Care |
3 | L: (364SA2200X) | C20467 | 364SA2200X | Adult Health |
3 | L: (364SC2300X) | C20468 | 364SC2300X | Chronic Care |
3 | L: (364SC1501X) | C20469 | 364SC1501X | Community Health/Public Health |
3 | L: (364SC0200X) | C20470 | 364SC0200X | Critical Care Medicine |
3 | L: (364SE0003X) | C20471 | 364SE0003X | Emergency |
3 | L: (364SE1400X) | C20472 | 364SE1400X | Ethics |
3 | L: (364SF0001X) | C20473 | 364SF0001X | Family Health |
3 | L: (364SG0600X) | C20474 | 364SG0600X | Gerontology |
3 | L: (364SH1100X) | C20475 | 364SH1100X | Holistic |
3 | L: (364SH0200X) | C20476 | 364SH0200X | Home Health |
3 | L: (364SI0800X) | C20477 | 364SI0800X | Informatics |
3 | L: (364SL0600X) | C20478 | 364SL0600X | Long-Term Care |
3 | L: (364SM0705X) | C20479 | 364SM0705X | Medical-Surgical |
3 | L: (364SN0000X) | C20480 | 364SN0000X | Neonatal |
3 | L: (364SN0800X) | C20481 | 364SN0800X | Neuroscience |
3 | L: (364SX0106X) | C20482 | 364SX0106X | Occupational Health |
3 | L: (364SX0200X) | C20483 | 364SX0200X | Oncology |
3 | L: (364SX0204X) | C20484 | 364SX0204X | Oncology, Pediatrics |
3 | L: (364SP0200X) | C20485 | 364SP0200X | Pediatrics |
3 | L: (364SP1700X) | C20486 | 364SP1700X | Perinatal |
3 | L: (364SP2800X) | C20487 | 364SP2800X | Perioperative |
3 | L: (364SP0808X) | C20488 | 364SP0808X | Psychiatric/Mental Health |
3 | L: (364SP0809X) | C20489 | 364SP0809X | Psychiatric/Mental Health, Adult |
3 | L: (364SP0807X) | C20490 | 364SP0807X | Psychiatric/Mental Health, Child & Adolescent |
3 | L: (364SP0810X) | C20491 | 364SP0810X | Psychiatric/Mental Health, Child & Family |
3 | L: (364SP0811X) | C20492 | 364SP0811X | Psychiatric/Mental Health, Chronically Ill |
3 | L: (364SP0812X) | C20493 | 364SP0812X | Psychiatric/Mental Health, Community |
3 | L: (364SP0813X) | C20494 | 364SP0813X | Psychiatric/Mental Health, Geropsychiatric |
3 | L: (364SR0400X) | C20495 | 364SR0400X | Rehabilitation |
3 | L: (364SS0200X) | C20496 | 364SS0200X | School |
3 | L: (364ST0500X) | C20497 | 364ST0500X | Transplantation |
3 | L: (364SW0102X) | C20498 | 364SW0102X | Women's Health |
2 | L: (367A00000X) | C20499 | 367A00000X | Midwife, Certified Nurse | A provider educated in the independent management of women's health and focusing particularly on pregnancy, childbirth, the post partum period, care of the newborn, family planning and gynecological needs of women and primary care of women. Certification requires education at the post secondary level in nursing and midwifery. Source: The American College of Nurse-Midwives, Position Statements, www.midwife.org/prof/defcnm.htm
2 | L: (367500000X) | C20500 | 367500000X | Nurse Anesthetist, Certified Registered | (1)A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548.
2 | S: NursePractitionerProviderCodes (363L00000X) | S20501 | 363L00000X | Nurse Practitioner | (1)A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. Source: (1)American Nurses' Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549.
3 | L: (363LA2100X) | C20502 | 363LA2100X | Acute Care |
3 | L: (363LA2200X) | C20503 | 363LA2200X | Adult Health |
3 | L: (363LC1500X) | C20504 | 363LC1500X | Community Health |
3 | L: (363LC0200X) | C20505 | 363LC0200X | Critical Care Medicine |
3 | L: (363LF0000X) | C20506 | 363LF0000X | Family |
3 | L: (363LG0600X) | C20507 | 363LG0600X | Gerontology |
3 | L: (363LN0000X) | C20508 | 363LN0000X | Neonatal |
3 | L: (363LN0005X) | C20509 | 363LN0005X | Neonatal, Critical Care |
3 | L: (363LX0001X) | C20510 | 363LX0001X | Obstetrics & Gynecology |
3 | L: (363LX0106X) | C20511 | 363LX0106X | Occupational Health |
3 | L: (363LP0200X) | C20512 | 363LP0200X | Pediatrics |
3 | L: (363LP0222X) | C20513 | 363LP0222X | Pediatrics, Critical Care |
3 | L: (363LP1700X) | C20514 | 363LP1700X | Perinatal |
3 | S: PhysicianAssistantProviderCodes (363A00000X) | S20519 | 363A00000X | Physician Assistant | A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
4 | L: (363AM0700X) | C20520 | 363AM0700X | Medical |
4 | L: (363AS0400X) | C20521 | 363AS0400X | Surgical |
3 | L: (363LP2300X) | C20515 | 363LP2300X | Primary Care |
3 | L: (363LP0808X) | C20516 | 363LP0808X | Psychiatric/Mental Health |
3 | L: (363LS0200X) | C20517 | 363LS0200X | School |
3 | L: (363LW0102X) | C20518 | 363LW0102X | Women's Health |
1 | S: PodiatricMedicineandSurgeryProvidersProviderCodes (210000000X) | S20522 | 210000000X | Podiatric Medicine and Surgery Providers | Broad category grouping licensed providers who renders services related to the human foot.
2 | L: (211D00000X) | C20523 | 211D00000X | Assistant, Podiatric | An individual who assists a podiatrist in tasks, such as exposing and developing x-rays; taking and recording patient histories; assisting in biomechanical evaluations and negative castings; preparing and sterilizing instruments and equipment; providing the patient with postoperative instructions; applying surgical dressings; preparing the patient for treatment, padding, and strapping; and performing routine office procedures. Source: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 622.
2 | S: PodiatristProviderCodes (213E00000X) | S20524 | 213E00000X | Podiatrist | A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
3 | L: (213EG0000X) | C20527 | 213EG0000X | General Practice |
3 | L: (213EP1101X) | C20528 | 213EP1101X | Primary Podiatric Medicine |
3 | L: (213EP0504X) | C20529 | 213EP0504X | Public Health |
3 | L: (213ER0200X) | C20530 | 213ER0200X | Radiology |
3 | L: (213ES0000X) | C20531 | 213ES0000X | Sports Medicine |
3 | L: (213ES0131X) | C20526 | 213ES0131X | Surgery, Foot |
3 | L: (213ES0103X) | C20525 | 213ES0103X | Surgery, Foot & Ankle |
1 | S: ResidentialTreatmentFacilitiesProviderCodes (320000000X) | S20766 | 320000000X | Residential Treatment Facilities | Live in facilities where patients or clients, who because of their physical, mental, or emotional condition, are not able to live independently, and who receive treatment appropriate to their particular needs in a less restrictive environment than an inpatient facility. For example, an RTC may provide educational training and therapy for children with emotional disturbances or continuing care and therapy for people with severe mental handicaps.
2 | L: (320800000X) | C20826 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
2 | L: (320900000X) | C20827 | 320900000X | Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
2 | L: (323P00000X) | C20767 | 323P00000X | Psychiatric Residential Treatment Facility | A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient's surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary.
2 | L: (322D00000X) | C20768 | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6.
2 | L: (320600000X) | C20828 | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently.
2 | L: (320700000X) | C20829 | 320700000X | Residential Treatment Facility, Physical Disabilities | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently.
2 | S: SubstanceAbuseDisorderRehabilitationFacilityProviderCodes (324500000X) | S20769 | 324500000X | Substance Use Disorder Rehabilitation Facility | A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
3 | L: (3245S0500X) | C20830 | 3245S0500X | Substance Abuse Treatment, Children | A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included.
1 | S: RespiratoryRehabilitativeandRestorativeServiceProvidersProviderCodes (220000000X) | S20532 | 220000000X | Respiratory, Rehabilitative and Restorative Service Providers | A provider who is trained and educated to perform services related to respiratory care, physical therapy, occupational therapy, rehabilitation and restorative services and may be licensed, certified or practice within the scope the scope of training.
2 | L: (221700000X) | C20533 | 221700000X | Art Therapist | (1) An individual who uses art to achieve the therapeutic goals of symptom relief, emotional integration, and recovery from or adjustment to illness or disability. (2) An art therapist uses a form of treatment that enables patients with mental or physical disabilities to use art as a way of expressing and dealing with feelings and inner conflicts. (3) An individual who uses arts modalities and creative processes during intentional intervention in therapeutic, rehabilitative, community, or educational settings to foster health, communication, and expression; promote the integration of physical, emotional, cognitive, and social functioning; enhance self-awareness; and facilitate change. Source: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 107. (2) Art Therapy Program, Marymount College, Tarrytown, NY (3) National Coalition of Arts
2 | L: (225600000X) | C20534 | 225600000X | Dance Therapist | The dance therapist, sometimes called a movement therapist, focuses on rhythmic body movements as a medium of physical and psychological change. Dance therapy is practiced more often with mental health patients than with physically disabled patients. A master's degree is required by the American Dance Therapy Association to award the credentials Dance Therapist Registered (DTR). Source: Joel A. DeLisa and Bruce M. Gans, Rehabilitation Medicine: Principles and Practice Second Edition, J.B. Lippincott Company, Philadelphia: 1993, p. 11
2 | L: (226300000X) | C20535 | 226300000X | Kinesiotherapist | A provider trained and educated in the applied science of medically prescribed therapeutic exercise, education and adapted physical activities designed to improve the quality of line and health of adults and children by developing physical fitness, increasing mobility and independence, and improving psychosocial behavior. The kinesiotherapist seeks a coach-player relationship in which he/she helps the patient/client reach the goal of becoming an independent, self-sustaining person. Kinesiotherapists, as compared with physical therapists, put more emphasis on geriatric care, reconditioning and fitness, and psychiatric care. A large percentage of kinesiotherapists practice in Veterans Administration hospitals. Source: The Kinesiotherapy Association.
2 | L: (225700000X) | C20536 | 225700000X | Massage Therapist | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
2 | L: (225A00000X) | C20537 | 225A00000X | Music Therapist | The music therapist works with patients with a broad variety of diagnoses and therapeutic goals. The interventions may involve musical performance with instruments, voice or body movements; listening to music; or attending musical events. Source: Joel A. DeLisa and Bruce M. Gans, Rehabilitation Medicine: Principles and Practice Second Edition, J.B. Lippincott Company, Philadelphia: 1993, p. 9-11
2 | L: (224Z00000X) | C20545 | 224Z00000X | Occupational Therapy Assistant | An Occupational Therapy assistant: provides medically prescribed occupational therapy services under the supervision of a registered occupational therapist to promote rehabilitation of patients in the hospital, home, schools and other settings; has completed a 2-year associate degree or one of the limited number of certificate programs; has met the qualifications as determined by the representative assembly and thus is entitled to use the term Certified occupational therapy assistant. Source: Valerie Walker, COTA Program Specialist, Practice Dept., Chronicle Guidance publications, American Occupational Therapy Association
2 | S: OccupationalTherapistProviderCodes (225X00000X) | S20538 | 225X00000X | Occupational Therapist | An occupational therapist is a person qualified by completion of an approved program in occupational therapy, licensed by the state and practicing within the scope of that license, or where licensure does not exist, certified by the American Occupational Therapy Certification Board. An occupational therapist evaluates the self-care, work and leisure performance skills of well and disabled clients and plans and implements programs to restore, develop or maintain the task performance skills necessary for daily living and for the client's particular occupational role.
3 | L: (225XE1200X) | C20539 | 225XE1200X | Ergonomics |
3 | L: (225XH1200X) | C20540 | 225XH1200X | Hand |
3 | L: (225XH1300X) | C20541 | 225XH1300X | Human Factors |
3 | L: (225XN1300X) | C20542 | 225XN1300X | Neurorehabilitation |
3 | L: (225XP0200X) | C20543 | 225XP0200X | Pediatrics |
3 | L: (225XR0403X) | C20544 | 225XR0403X | Rehabilitation, Driver |
2 | L: (225000000X) | C20546 | 225000000X | Orthotics/Prosthetics Fitter | (1) An individual who, under the guidance of and in consultation with the orthotist/prosthetist, fabricates orthotics/prosthetics in such a manner as to provide maximum fit, function, cosmesis and workmanship. (2) An individual who, under the direction of a orthotist/prothetist, follows prescriptions and specifications to determine a device, such as a brace, to be made and the materials and tools needed to make the device. A technician then develops the devices. Source: (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 576.
2 | L: (222Z00000X) | C20547 | 222Z00000X | Orthotist | An individual skilled in the practice, making, use and application to individual cases of an orthopedic appliance or apparatus used to support, align, prevent or correct deformities or to improve the function of movable parts of the body. Source: Dorland's Illustrated Medical Dictionary, 26th Edition, Philadelphia: W.. Saunders Company, 1981.
2 | L: (225200000X) | C20559 | 225200000X | Physical Therapy Assistant | (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of the physical therapist assistant. The PTA performs physical therapy procedures and related tasks that have been selected and delegated by the supervising physical therapist. Duties of the PTA include assisting the physical therapist in implementing treatment programs, training patients in exercised and activities of daily living, conducting treatments, and reporting to the physical therapist on the patient's responses. In addition to direct patient care, the PTA may also perform such functions as patient transport, and clinic or equipment preparation and maintenance. Currently more than half of all states require PTAs to be licensed, registered or certified. (2) An individual who works under the supervision of a physical therapist to assist him or her in providing physical therapy services. A physical therapy assistant may, for instance, help patients follow an appropriate exercise program that will increase their strength, endurance, coordination, and range of motion and train patients to perform activities of daily life. Source: (1) American Physical Therapy Association, P.O. Box 37257, Washington, D.C. 20013. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612
2 | S: PhysicalTherapistProviderCodes (225100000X) | S20548 | 225100000X | Physical Therapist | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT's assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient's strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612
3 | L: (2251C2600X) | C20549 | 2251C2600X | Cardiopulmonary |
3 | L: (2251E1300X) | C20550 | 2251E1300X | Electrophysiology, Clinical |
3 | L: (2251E1200X) | C20551 | 2251E1200X | Ergonomics |
3 | L: (2251G0304X) | C20552 | 2251G0304X | Geriatrics |
3 | L: (2251H1200X) | C20553 | 2251H1200X | Hand |
3 | L: (2251H1300X) | C20554 | 2251H1300X | Human Factors |
3 | L: (2251N0400X) | C20555 | 2251N0400X | Neurology |
3 | L: (2251X0800X) | C20556 | 2251X0800X | Orthopedic |
3 | L: (2251P0200X) | C20557 | 2251P0200X | Pediatrics |
3 | L: (2251S0007X) | C20558 | 2251S0007X | Sports |
2 | L: (224P00000X) | C20560 | 224P00000X | Prosthetist | An individual skilled in the practice, making, use, and application to individual cases of an artificial substitute for a missing body part, such as an arm or leg, eye or tooth, used for functional or cosmetic reasons, or both Source: Dorland's Illustrated Medical Dictionary. 26th edition. Philadelphia: W.B. Saunders Company, 1981.
2 | L: (225B00000X) | C20561 | 225B00000X | Pulmonary Function Technologist | An individual who is trained and qualified in the techniques and procedures for assessment and treatment of diseases of the lungs and airways such as pneumonia, cancer, pleurisy, asthma, bronchitis, emphysema, and other disorders. Therapy involves assessment of lung functions, assisting the patient in therapeutic exercise and monitoring mechanical assistance to ventilation.
2 | L: (225800000X) | C20562 | 225800000X | Recreation Therapist | A recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in that behavior and promote the growth and development of the patient. Source: Joel A. DeLisa and Bruce M. Gans, Rehabilitation Medicine: Principles and Practice Second Edition, J.B. Lippincott Company, Philadelphia: 1993, p. 7
2 | L: (225400000X) | C20566 | 225400000X | Rehabilitation Practitioner | A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.
2 | S: RehabilitationCounselorProviderCodes (225C00000X) | S20563 | 225C00000X | Rehabilitation Counselor | An individual trained and educated in a systematic process of assisting persons with physical, mental, developmental, cognitive, and emotional disabilities to achieve their personal, career, and independent living goals assessment and appraisal, diagnosis and treatment planning, career (vocational) counseling, individual and group counseling interventions for adjustments to the medical and psychosocial impact of disability, case management, program evaluation and research, job analysis and placement counseling, and consultation on rehabilitation resources and technology. Certification generally requires a Master's degree with specialized courses in rehabilitation processes and technology. Sources: Commission on Rehabilitation Counselor Certification and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.
3 | L: (225CA2400X) | C20564 | 225CA2400X | Assistive Technology Practitioner |
3 | L: (225CA2500X) | C20565 | 225CA2500X | Assistive Technology Supplier |
2 | S: RespiratoryTherapistCertifiedProviderCodes (227800000X) | S20567 | 227800000X | Respiratory Therapist, Certified | A respiratory therapist is a person who has graduated from a respiratory therapy program accredited by the Committee on Allied Health Education and Accreditation, and where applicable, is licensed by the state and is practicing within the scope of that license. A respiratory therapist administers oxygen and other gases and provides assistance with equipment to patients with either acute or chronic breathing difficulties, often within the home.
3 | L: (2278C0205X) | C20568 | 2278C0205X | Critical Care | Respiratory emergencies are commonplace in the treatment of critical care patients. Included in the assessment measurements conducted by the respiratory therapist in the critical care settings are arterial blood gas puncture and analysis, intrarterial monitoring, bedside measurements of lung mechanics, hemodynamic monitoring, and inspired and expired gas measurements. This is coupled with the initiation and management of mechanical ventilation patients.
3 | L: (2278E0002X) | C20570 | 2278E0002X | Emergency Care | The immediate availability of diagnostic and therapeutic cardiopulmonary services in the assessment and management of trauma victims, patients requiring airway management and others requiring emergency care.
3 | L: (2278G1100X) | C20571 | 2278G1100X | General Care | This level of care includes diagnostics testing, therapeutics, monitoring, rehabilitation of patients with disorders of the cardiopulmonary system, as well as, education of the patient and family in regard to those disorders.
3 | L: (2278G0305X) | C20572 | 2278G0305X | Geriatric Care | Care of older patients who have age and/or disease related decremental pulmonary changes. Diagnosis and treatment is very important for this group since chronic lung disease is the major cause of morbidity and mortality among them. Furthermore, as this segment of the population increases, life expectancy is being extended.
3 | L: (2278H0200X) | C20573 | 2278H0200X | Home Care | Home care fosters individual responsibility for self-management of chronic respiratory conditions. It includes individualized assessment based plans of care service developed to promote safe, proper, and sustained use of prescribed respiratory therapy medications, equipment, and techniques in the home.
3 | L: (2278P3900X) | C20574 | 2278P3900X | Neonatal/Pediatrics | The care and treatment of premature infants, newborns and children. This includes management of mechanical ventilation, assessment, diagnostics and generalized respiratory treatments.
3 | L: (2278P3800X) | C20575 | 2278P3800X | Palliative/Hospice | A coordinated plan of care to help dying patients and their families handle the burden of terminal care. Effective secretion management and relief of dyspnea are paramount in caring for patients with end-stage pulmonary disease.
3 | L: (2278E1000X) | C20569 | 2278E1000X | Patient Education | The focus of patient and family education activities is to promote knowledge of disease process, medical therapy, and self help. Respiratory therapists are uniquely qualified to provide this service in regard to cardiopulmonary diseases and injury.
3 | L: (2278P4000X) | C20576 | 2278P4000X | Patient Transport | Transport respiratory therapist provide patient assessment, initiation of treatment modalities and continued monitoring of patient status of the critically ill and injured patients with special attention to advanced airway and ventilator management. The transport respiratory therapist knowledge and experience with complex neonatal, pediatric and adult patient care issues provides them with an expertise to assist with any patient care issue in a variety of transport modes.
3 | L: (2278P1004X) | C20577 | 2278P1004X | Pulmonary Diagnostics | Included in the area of pulmonary diagnostics are the following; collection and analysis of physiological specimens, interpretation of physiological data, administration of tests of the cardiopulmonary system, and the conduct of both neurophysiological and sleep disorders studies.
3 | L: (2278P1006X) | C20578 | 2278P1006X | Pulmonary Function Technologist | An individual who is trained and qualified to perform pulmonary diagnostic tests. In the course of conducting these tests, the Pulmonary Function Technologist is able to setup, calibrate, maintain, and ensure the quality assurance of the pulmonary function testing equipment. In any laboratory, clinical or patient care setting the technologist instructs patients, elicits cooperation, performs procedures, monitors patient response, and evaluates patient performance. Tests results are calculated, compared with predicted normal ranges, and evaluated for reliability. The technologist collects clinical history data and evaluates the clinical implications of the test results.
3 | L: (2278P1005X) | C20579 | 2278P1005X | Pulmonary Rehabilitation | The respiratory therapist can assist the chronic pulmonary patient in returning to an optimal role in society by providing an effective program. It includes bronchopulmonary drainage, exercise therapy, and patient education.
3 | L: (2278S1500X) | C20580 | 2278S1500X | SNF/Subacute Care | Care of residents in a long-term care environment. Respiratory modalities delivered include those similar in the general care and critical care areas but provided to less critical patients.
2 | S: RespiratoryTherapistRegisteredProviderCodes (227900000X) | S20581 | 227900000X | Respiratory Therapist, Registered | A respiratory therapist is a person who has graduated from a respiratory therapy program accredited by the Committee on Allied Health Education and Accreditation, and where applicable, is licensed by the state and is practicing within the scope of that license. A respiratory therapist administers oxygen and other gases and provides assistance with equipment to patients with either acute or chronic breathing difficulties, often within the home.
3 | L: (2279C0205X) | C20582 | 2279C0205X | Critical Care | Respiratory emergencies are commonplace in the treatment of critical care patients. Included in the assessment measurements conducted by the respiratory therapist in the critical care settings are arterial blood gas puncture and analysis, intrarterial monitoring, bedside measurements of lung mechanics, hemodynamic monitoring, and inspired and expired gas measurements. This is coupled with the initiation and management of mechanical ventilation patients.
3 | L: (2279E0002X) | C20584 | 2279E0002X | Emergency Care | The immediate availability of diagnostic and therapeutic cardiopulmonary services in the assessment and management of trauma victims, patients requiring airway management and others requiring emergency care.
3 | L: (2279G1100X) | C20585 | 2279G1100X | General Care | This level of care includes diagnostics testing, therapeutics, monitoring, rehabilitation of patients with disorders of the cardiopulmonary system, as well as, education of the patient and family in regard to those disorders.
3 | L: (2279G0305X) | C20586 | 2279G0305X | Geriatric Care | Care of older patients who have age and/or disease related decremental pulmonary changes. Diagnosis and treatment is very important for this group since chronic lung disease is the major cause of morbidity and mortality among them. Furthermore, as this segment of the population increases, life expectancy is being extended.
3 | L: (2279H0200X) | C20587 | 2279H0200X | Home Care | Home care fosters individual responsibility for self-management of chronic respiratory conditions. It includes individualized assessment based plans of care service developed to promote safe, proper, and sustained use of prescribed respiratory therapy medications, equipment, and techniques in the home.
3 | L: (2279P3900X) | C20588 | 2279P3900X | Neonatal/Pediatrics | The care and treatment of premature infants, newborns and children. This includes management of mechanical ventilation, assessment, diagnostics and generalized respiratory treatments.
3 | L: (2279P3800X) | C20589 | 2279P3800X | Palliative/Hospice | A coordinated plan of care to help dying patients and their families handle the burden of terminal care. Effective secretion management and relief of dyspnea are paramount in caring for patients with end-stage pulmonary disease.
3 | L: (2279E1000X) | C20583 | 2279E1000X | Patient Education | The focus of patient and family education activities is to promote knowledge of disease process, medical therapy, and self help. Respiratory therapists are uniquely qualified to provide this service in regard to cardiopulmonary diseases and injury.
3 | L: (2279P4000X) | C20590 | 2279P4000X | Patient Transport | Transport respiratory therapist provide patient assessment, initiation of treatment modalities and continued monitoring of patient status of the critically ill and injured patients with special attention to advanced airway and ventilator management. The transport respiratory therapist knowledge and experience with complex neonatal, pediatric and adult patient care issues provides them with an expertise to assist with any patient care issue in a variety of transport modes.
3 | L: (2279P1004X) | C20591 | 2279P1004X | Pulmonary Diagnostics | Included in the area of pulmonary diagnostics are the following; collection and analysis of physiological specimens, interpretation of physiological data, administration of tests of the cardiopulmonary system, and the conduct of both neurophysiological and sleep disorders studies.
3 | L: (2279P1006X) | C20592 | 2279P1006X | Pulmonary Function Technologist | An individual who is trained and qualified to perform pulmonary diagnostic tests. In the course of conducting these tests, the Pulmonary Function Technologist is able to setup, calibrate, maintain, and ensure the quality assurance of the pulmonary function testing equipment. In any laboratory, clinical or patient care setting the technologist instructs patients, elicits cooperation, performs procedures, monitors patient response, and evaluates patient performance. Tests results are calculated, compared with predicted normal ranges, and evaluated for reliability. The technologist collects clinical history data and evaluates the clinical implications of the test results.
3 | L: (2279P1005X) | C20593 | 2279P1005X | Pulmonary Rehabilitation | The respiratory therapist can assist the chronic pulmonary patient in returning to an optimal role in society by providing an effective program. It includes bronchopulmonary drainage, exercise therapy, and patient education.
3 | L: (2279S1500X) | C20594 | 2279S1500X | SNF/Subacute Care | Care of residents in a long-term care environment. Respiratory modalities delivered include those similar in the general care and critical care areas but provided to less critical patients.
2 | S: SpecialistTechnologistProviderCodes (225500000X) | S20595 | 225500000X | Specialist/Technologist | General classification identifying individuals who are trained on a specific piece of equipment or technical procedure.
3 | L: (2255A2300X) | C20596 | 2255A2300X | Athletic Trainer |
3 | L: (2255R0406X) | C20597 | 2255R0406X | Rehabilitation, Blind |
1 | S: RespiteCareFacilityProviderCodes (380000000X) | S20770 | 380000000X | Respite Care Facility | A facility with dorm rooms where individuals who are unable to care for themselves may stay on a short term basis overnight to allow relief to persons normally providing care to them.
2 | S: RespiteCareProviderCodes (385H00000X) | S20771 | 385H00000X | Respite Care |
3 | L: (385HR2050X) | C20831 | 385HR2050X | Respite Care Camp | A camping facility that provides specialized respite care to individuals requiring enhanced services to enable them to remain in the community, (e.g., those with developmental delays, mental retardation, mental/behavioral disorders). The staff must have training in working with the target populations and dealing with emergency situations which might be related to or exacerbate the individual's condition.
3 | L: (385HR2055X) | C20832 | 385HR2055X | Respite Care, Mental Illness, Child | A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers.
3 | L: (385HR2060X) | C20833 | 385HR2060X | Respite Care, Mental Retardation and/or Developmental Disabilities, Child | A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental retardation and/or developmental disabilities as respite for the regular caregivers.
3 | L: (385HR2065X) | C20834 | 385HR2065X | Respite Care, Physical Disabilities, Child | A facility or distinct part of a facility that providers short term, residential care to children, diagnosed with complex or profound disabilities as respite for the regular caregivers.
1 | S: SpeechLanguageandHearingProvidersProviderCodes (230000000X) | S20598 | 230000000X | Speech, Language and Hearing Providers | A provider who renders services to improve communicative skills of people with language, speech and hearing impairments.
2 | L: (237600000X) | C20602 | 237600000X | Audiologist-Hearing Aid Fitter | An audiologist/hearing aid fitter is the professional who specializes in evaluating and treating people with hearing loss, conducts a wide variety of tests to determine the exact nature of an individual's hearing problem, presents a variety of treatment options to patients, dispenses and fits hearing aids, administers tests of balance to evaluate dizziness and provides hearing rehabilitation training. This classification should be used where individuals are licensed as "audiologist-hearing aid fitters" as opposed to states that license individuals as "audiologists". Source: American Academy of Audiology, 1735 N. Lynn St, Suite 950, Arlington VA 22209, (800)AAA-2336)
2 | S: AudiologistProviderCodes (231H00000X) | S20599 | 231H00000X | Audiologist | (1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master's degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy. Source: (1) American Speech-Language-Hearing Association, (1996, Spring) Scope of practice in Audiology, p. 2
3 | L: (231HA2400X) | C20600 | 231HA2400X | Assistive Technology Practitioner |
3 | L: (231HA2500X) | C20601 | 231HA2500X | Assistive Technology Supplier |
2 | L: (237700000X) | C20603 | 237700000X | Hearing Instrument Specialist | Individuals who test hearing for the selection, adaptation, fitting, adjusting, servicing, and sale of hearing aids. Hearing Instrument Specialist is a designation provided individuals who qualify by the National Hearing Aid Society
2 | L: (235Z00000X) | C20607 | 235Z00000X | Speech-Language Pathologist | A speech pathologist is a person qualified by a master's degree in speech-language pathology, and where applicable, licensed by the state and practicing within the scope of the license. Also, known as speech therapist, a speech pathologist evaluates patients with language and speech impairments or disorders, whether arising from physiological and neurological disturbances, defective articulation or foreign dialects, and conducts remedial programs designed to restore or improve their communication efficacy. Speech pathologists assess and treat persons with speech, language, voice, and fluency disorders.
2 | S: SpeechLanguageTechnologistProviderCodes (235500000X) | S20604 | 235500000X | Specialist/Technologist | General classification identifying individuals who are trained on a specific piece of equipment or technical procedure.
3 | L: (2355A2700X) | C20605 | 2355A2700X | Audiology Assistant |
3 | L: (2355S0801X) | C20606 | 2355S0801X | Speech-Language Assistant |
1 | S: SuppliersProviderCodes (330000000X) | S20772 | 330000000X | Suppliers | A provider, other than a pharmacy, who supplies healthcare related products. The term supplier also includes pharmacies.
2 | L: (331L00000X) | C20773 | 331L00000X | Blood Bank | An institution (organization or distinct part thereof) that performs, or is responsible for the performance of, the collection, processing, storage and/or issuance of human blood and blood components, intended for transfusion. The institution may also collect, process, and/or distribute human tissue, including bone marrow and peripheral blood progenitor cells, intended for transplantation. Source: American Association of Blood Banks, Standards for Blood Banks and Tranfusion, 17th ed.
2 | S: DurableMedicalEquipmentandMedicalSuppliesProviderCodes (332B00000X) | S20774 | 332B00000X | Durable Medical Equipment & Medical Supplies | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
3 | L: (332BC3200X) | C20775 | 332BC3200X | Customized Equipment |
3 | L: (332BD1200X) | C20776 | 332BD1200X | Dialysis Equipment & Supplies |
3 | L: (332BN1400X) | C20777 | 332BN1400X | Nursing Facility Supplies |
3 | L: (332BX2000X) | C20778 | 332BX2000X | Oxygen Equipment & Supplies |
3 | L: (332BP3500X) | C20779 | 332BP3500X | Parenteral & Enteral Nutrition |
2 | L: (332G00000X) | C20780 | 332G00000X | Eye Bank | An eye bank procures and distributes eyes for transplant, education and research. To promote patient safety, donated eyes and donor medial histories are evaluated based on strict Eye Bank Association of America Medical Standards
2 | L: (332H00000X) | C20781 | 332H00000X | Eyewear Supplier | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
2 | L: (332S00000X) | C20782 | 332S00000X | Hearing Aid Equipment | The manufacture and/or sale of electronic hearing aids, their component parts, and related products and services on a national basis.
2 | L: (332U00000X) | C20783 | 332U00000X | Home Delivered Meals | Home-delivered meals are those services or activities designed to prepare and deliver one or more meals a day to an individual's residence in order to prevent institutionalization, malnutrition, and feelings of isolation. Component services or activities may include the cost of personnel, equipment, and food; assessment of nutritional and dietary needs; nutritional education and counseling; socialization services; and information and referral. Source: Code of Federal Regulations #45, Part 96, Appendix A, Uniform Definition of Services.
2 | L: (335U00000X) | C20784 | 335U00000X | Organ Procurement Organization | A federally designated organization that works with hospital personnel in retrieval of organs for transplantation. The federal government designates an OPO's service area and the hospitals with which an OPO is to establish working relationships.
2 | L: (333600000X) | C20785 | 333600000X | Pharmacy | A facility used by pharmacists for the compounding and dispensing of medicinal preparations (drug store). A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs through a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
2 | L: (335V00000X) | C20786 | 335V00000X | Portable Xray Supplier | A supplier of diagnostic x-ray services furnished in a place or residence used as the patient's home or, in certain circumstances, in an institution, where the institution cannot bill for the services. Portable x-ray services include: skeletal films involving arms and legs, pelvis, vertebral column, and skull; chest films which do not involve the use of contrast media (except routine screening procedures and tests in connection with routine physical examinations); and abdominal films which do not involve the use of contrast media. Procedures and examinations which are excluded from portable x-ray services include the following: procedures involving fluoroscopy; procedures involving the use of contrast media; procedures requiring the administration of a substance to the patient or injection of a substance into the patient and/or special manipulation of the patient; procedures which require special medical skill or knowledge possessed by a doctor of medicine or doctor of osteopathy or which require that medical judgment be exercised; procedures requiring special technical competency and/or special equipment or materials; routine screening procedures; and procedures which are not of a diagnostic nature. Source: Paraphrased from the Medicare Carriers Manual, Section 2070.4.
2 | L: (335E00000X) | C20787 | 335E00000X | Prosthetic/Orthotic Supplier | An organization which supplies or vends orthopedic appliances or apparatuses and artificial body parts used to support, align, prevent, or correct deformities or to replace or improve function of body parts.
1 | S: TechnologistTechnicianandOtherTechnicalServiceProvidersProviderCodes (240000000X) | S20608 | 240000000X | Technologist, Technician, and Other Technical Service Providers | A broad category grouping providers who apply scientific knowledge in solving practical or theoretical problems or applies technical procedures in accordance with their training and experience.
2 | S: RadiologicTechnologistProviderCodes (247100000X) | S20609 | 247100000X | Radiologic Technologist | An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment.
3 | L: (2471B0102X) | C20610 | 2471B0102X | Bone Densitometry |
3 | L: (2471C1106X) | C20611 | 2471C1106X | Cardiac-Interventional Technology |
3 | L: (2471C1101X) | C20612 | 2471C1101X | Cardiovascular-Interventional Technology |
3 | L: (2471C3401X) | C20613 | 2471C3401X | Computed Tomography |
3 | L: (2471M1202X) | C20614 | 2471M1202X | Magnetic Resonance Imaging |
3 | L: (2471M2300X) | C20615 | 2471M2300X | Mammography |
3 | L: (2471N0900X) | C20616 | 2471N0900X | Nuclear Medicine Technology |
3 | L: (2471Q0001X) | C20617 | 2471Q0001X | Quality Management |
3 | L: (2471R0002X) | C20618 | 2471R0002X | Radiation Therapy |
3 | L: (2471C3402X) | C20619 | 2471C3402X | Radiography |
3 | L: (2471S1302X) | C20620 | 2471S1302X | Radiologic Technologist, Sonography |
3 | L: (2471V0105X) | C20621 | 2471V0105X | Vascular Sonography |
3 | L: (2471V0106X) | C20622 | 2471V0106X | Vascular-Interventional Technology |
2 | S: SpecialistTechnologistCardiovascularProviderCodes (246X00000X) | S20623 | 246X00000X | Specialist/Technologist Cardiovascular | An allied health professional who performs diagnostic examinations at the request or direction of a physician in one or more of the following three areas: invasive cardiology, noninvasive cardiology, and noninvasive peripheral vascular study. Cardiovascular technologists are one type of allied health professional for which the Committee on Allied Health Education and Accreditation has accredited education programs Source: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 159.
3 | L: (246XC2901X) | C20624 | 246XC2901X | Cardiovascular Invasive Specialist |
3 | L: (246XS1301X) | C20625 | 246XS1301X | Specialist/Technologist Cardiovascular, Sonography |
3 | L: (246XC2903X) | C20626 | 246XC2903X | Vascular Specialist |
2 | S: SpecialistTechnologistHealthInformationProviderCodes (246Y00000X) | S20627 | 246Y00000X | Specialist/Technologist, Health Information | An individual with a high school diploma, on-the-job experience and coding education from seminars or college classes who passes a national certification examination in either inpatient and outpatient facility services coding, or physician services coding. Source: American Health Information Management Association, Chicago, IL, 1996.
3 | L: (246YC3301X) | C20628 | 246YC3301X | Coding Specialist, Hospital Based |
3 | L: (246YC3302X) | C20629 | 246YC3302X | Coding Specialist, Physician Office Based |
3 | L: (246YR1600X) | C20630 | 246YR1600X | Registered Record Administrator |
2 | S: SpecialistTechnologistOtherProviderCodes (246Z00000X) | S20631 | 246Z00000X | Specialist/Technologist, Other | General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines.
3 | L: (246ZA2600X) | C20632 | 246ZA2600X | Art, Medical |
3 | L: (246ZB0500X) | C20633 | 246ZB0500X | Biochemist |
3 | L: (246ZB0301X) | C20634 | 246ZB0301X | Biomedical Engineering |
3 | L: (246ZB0302X) | C20635 | 246ZB0302X | Biomedical Photographer |
3 | L: (246ZB0600X) | C20636 | 246ZB0600X | Biostatistician |
3 | L: (246ZE0500X) | C20637 | 246ZE0500X | EEG |
3 | L: (246ZE0600X) | C20638 | 246ZE0600X | Electroneurodiagnostic |
3 | L: (246ZG1000X) | C20639 | 246ZG1000X | Geneticist, Medical (PhD) |
3 | L: (246ZG0701X) | C20640 | 246ZG0701X | Graphics Methods |
3 | L: (246ZI1000X) | C20641 | 246ZI1000X | Illustration, Medical |
3 | L: (246ZN0300X) | C20642 | 246ZN0300X | Nephrology |
3 | L: (246ZS0400X) | C20643 | 246ZS0400X | Surgical |
2 | S: SpecialistTechnologistPathologyProviderCodes (246Q00000X) | S20644 | 246Q00000X | Specialist/Technologist, Pathology | (1) An individual educated and trained in clinical chemistry, microbiology or other biological sciences; and in gathering data on the blood, tissues, and fluids in the human body. Tests and procedures performed or supervised center on major areas of hematology, microbiology, immunohematology, immunology, clinical chemistry and urinalysis. Education and certification requires the equivalent of an associate degree and alternative combinations of accredited training and experience. (2) A specially trained individual who works under the direction of a pathologist, other physician, or scientist, and performs specialized chemical, microscopic, and bacteriological tests of human blood, tissue, and fluids. Also known as medical technologists, they perform and supervise tests and procedures in clinical chemistry, immunology, serology, bacteriology, hematology, parasitology, mycology, urinalysis, and blood banking. The work requires the correlation of test results with other data, interpretation of test findings, and exercise of independent judgment. The minimum educational requirement (for one of several certification programs in medical technology) is a baccalaureate degree with appropriate science course requirements, plus a twelve-month, structured, AMA approved medical technology program and an examination; or a baccalaureate degree with appropriate science course requirements and experience.
3 | L: (246QB0000X) | C20645 | 246QB0000X | Blood Banking |
3 | L: (246QC1000X) | C20646 | 246QC1000X | Chemistry |
3 | L: (246QC2700X) | C20647 | 246QC2700X | Cytotechnology |
3 | L: (246QH0401X) | C20648 | 246QH0401X | Hemapheresis Practitioner |
3 | L: (246QH0000X) | C20649 | 246QH0000X | Hematology |
3 | L: (246QH0600X) | C20650 | 246QH0600X | Histology |
3 | L: (246QI0000X) | C20651 | 246QI0000X | Immunology |
3 | L: (246QL0900X) | C20652 | 246QL0900X | Laboratory Management |
3 | L: (246QL0901X) | C20653 | 246QL0901X | Laboratory Management, Diplomate |
3 | L: (246QM0706X) | C20654 | 246QM0706X | Medical Technologist |
3 | L: (246QM0900X) | C20655 | 246QM0900X | Microbiology |
2 | L: (246W00000X) | C20656 | 246W00000X | Technician, Cardiology | An individual who has knowledge of specific techniques, instruments, and equipment required in performing specific cardiovascular/peripheral vascular diagnostic procedures.
2 | S: TechnicianHealthInformationProviderCodes (247000000X) | S20657 | 247000000X | Technician, Health Information | Preferred term for an Accredited Record Technician who is an individual with an associate's degree from an accredited college or independent study program who is skilled in analyzing health information and in examination of medical records for accuracy, reporting of patient data for reimbursement, and creation of disease registries for researchers. Source: American Health Information Management Association, Chicago, IL, 1996.
3 | L: (2470A2800X) | C20658 | 2470A2800X | Assistant Record Technician |
2 | S: TechnicianOtherProviderCodes (247200000X) | S20659 | 247200000X | Technician, Other | A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user. Sources: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988; Dorland's Illustrated Medical Dictionary, 26th Edition. Philadelphia: W.B. Saunders Company, 1981; and Webster's II New Riverside University Dictionary. Boston: Riverside Publishing Company, 1984.
3 | L: (2472B0301X) | C20660 | 2472B0301X | Biomedical Engineering |
3 | L: (2472D0500X) | C20661 | 2472D0500X | Darkroom |
3 | L: (2472E0500X) | C20662 | 2472E0500X | EEG |
3 | L: (2472R0900X) | C20663 | 2472R0900X | Renal Dialysis |
3 | L: (2472V0600X) | C20664 | 2472V0600X | Veterinary |
2 | S: TechnicianPathologyProviderCodes (246R00000X) | S20665 | 246R00000X | Technician, Pathology | An individual with knowledge of specific techniques and instruments who performs all of the routine tests in a medical laboratory and who has the ability to discriminate between similar factors that directly affect procedures and results.
3 | L: (246RH0600X) | C20666 | 246RH0600X | Histology |
3 | L: (246RM2200X) | C20667 | 246RM2200X | Medical Laboratory |
3 | L: (246RP1900X) | C20668 | 246RP1900X | Phlebotomy |
1 | S: TransportationServicesProviderCodes (340000000X) | S20788 | 340000000X | Transportation Services | A provider who moves a patient, tissue specimen or equipment from one location to another
2 | S: AmbulanceProviderCodes (341600000X) | S20789 | 341600000X | Ambulance | An emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane). Source: Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 37.
3 | L: (3416A0800X) | C20790 | 3416A0800X | Air |
3 | L: (3416L0300X) | C20791 | 3416L0300X | Land |
3 | L: (3416S0300X) | C20792 | 3416S0300X | Sea |
2 | L: (347B00000X) | C20793 | 347B00000X | Bus | A public or private organization or business licensed to provide bus services.
2 | L: (343900000X) | C20794 | 343900000X | Non-emergency Medical Transport (VAN) | A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations.
2 | L: (347C00000X) | C20795 | 347C00000X | Private Vehicle | An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.
2 | L: (343800000X) | C20796 | 343800000X | Secured Medical Transport (VAN) | A public or privately owned transportation service with vehicles, specially equipped to provide enhanced safety, security and passenger restraint, and staffed by one or more individuals trained to work with patients in crisis situations resulting from mental or emotional illness and/or substance abuse.
2 | L: (344600000X) | C20797 | 344600000X | Taxi | A land commercial vehicle used for the transporting of persons in non-emergency situations. The vehicle meets local, county or state regulations set forth by the jurisdictions where it is located.
2 | L: (347D00000X) | C20798 | 347D00000X | Train | An organization or business licensed to provide passenger train service, including light rail, subway, and traditional services.
2 | L: (347E00000X) | C20799 | 347E00000X | Transportation Broker | A public or private organization or business contracted to arrange non-emergency medical transportation services, including appropriate ancillary services, e.g., lodging.

Return to contents

Last Published: 03/27/2006 3:35 AM

HL7® Version 3 Standard, © 2005 Health Level Seven®, Inc. All Rights Reserved.

HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off