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Finding Taxonomy Codes for the CMS-1500

Field 24J Grey of Form CMS 1500 requires a taxonomy code when the rendering provider is a health care provider. A taxonomy code represents the provider’s classification, such as family medicine, anesthesiologist, or physician assistant.

Frequently Asked Question

Q: How do I find a Taxonomy Code?

A: A provider’s taxonomy code can be easily found by consulting the National Plan & Provider Enumeration System (NPPES) at: https://npiregistry.cms.hhs.gov/

Explanation

Taxonomy Codes are important because claims administrators reimburse differently for the exact same procedure depending on the provider’s classification. For example, a chiropractor (111N00000X  - CHIROPRACTOR) receives greater reimbursement than a physician assistant (363A00000X - PHYSICIAN ASSISTANT).

A provider’s taxonomy code can be easily found by consulting the National Plan & Provider Enumeration System (NPPES) at: https://npiregistry.cms.hhs.gov/

The NPPES system can look up provider information by NPI, last name, practice address, or a number of other parameters. A provider’s NPPES information includes not only his or her taxonomy code but also such useful information as state license number, NPI number, and identifiers for other programs such as Medicaid and Medicare.

Pro-Tip: Remember that the taxonomy code must be for the rendering provider, meaning the provider who actually performed the services. This may not necessarily be the supervising provider.

NPPES page:

NPPES NPI search page:

 

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