The CMS-1500 Form requires providers to include the taxonomy code of rendering providers in Field 24J Grey. Below are simple instructions to determine the correct taxonomy code.
Taxonomy Codes for the CMS-1500
The California Billing and Payment Guide issued by the Division of Workers’ Comp (DWC) requires providers to complete the CMS-1500 Form with the taxonomy code of the rendering provider when the rendering provider is a health care provider. A taxonomy code describes the Provider or Organization’s type, classification, and area of specialization. For billing purposes, the taxonomy code is entered into Field 24J Grey on the CMS-1500 form.
Per the California Official Medical Fee Schedule (OMFS) the reimbursement amounts for treatment can differ based on the provider’s Taxonomy Codes. For example, a chiropractor (111N00000X - CHIROPRACTOR) receives greater reimbursement than a physician assistant (363A00000X - PHYSICIAN ASSISTANT).
How To Determine A Taxonomy Code
A provider’s taxonomy code can easily be found on the National Plan & Provider Enumeration System (NPPES) website.
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.
For more information on filing compliant CMS-1500 Forms, please review DaisyBill’s California Billing Guide.
Additional Information
WPC Health Care Provider Taxonomy Code Set
DaisyBill Resources
Webinar: California Workers’ Compensation: Master the Original Bill
REQUEST DEMO