Section title: Requests for Interpretation
Use of state assigned taxonomy codes (837)

Can a state assigned taxonomy code be submitted on the 837P and/or 837I?


Due to recent state legislation, the 837 transaction will start to be used between behavioral health crisis provider and health plans. In addition to their NPPES taxonomy code(s), many of these providers have been given a taxonomy code by the state health care authority, which is not an NPPES assigned code.

RFI Response

The PRV02 DE 128 has Code Source 682: Health Care Provider Taxonomy as the source for this data element. The National Uniform Claim Committee maintains the Taxonomy Codes. The code must be from this code set.

RFI Recommendation

Refer to the NUCC website for information about the NUCC taxonomy code set and how to self-select or request a new code.

"005010X224 005010X223"