Nonphysician Practitioner, Supplier, and Provider Specialty

10.8.3 - Nonphysician Practitioner, Supplier, and Provider Specialty Codes (Rev. 10124, Issued: 05-08-2020, Effective: 10-01-2020, Implementation:10-05-2020) The following list of 2-digit codes and narrative describe the kind of medicine non- physician practitioners or other healthcare providers/suppliers practice. Code Non-physician Practitioner/Supplier/Provider Specialty 15 Speech Language Pathologists 31 Intensive Cardiac Rehabilitation 32 Anesthesiologist Assistant 42 Certified Nurse Midwife (effective July 1, 1988) 43 Certified Registered Nurse Anesthetist (CRNA) 45 Mammography Screening Center 47 Independent Diagnostic Testing Facility (IDTF) 49 Ambulatory Surgical Center 50 Nurse Practitioner 51 Medical supply company with orthotic personnel certified by an accrediting organization 52 Medical supply company with prosthetic personnel certified by an accrediting organization 53 Medical supply company with prosthetic/orthotic personnel certified by an accrediting organization 54 Medical supply company not included in 51, 52, or 53 55 Individual orthotic personnel certified by an accrediting organization 56 Individual prosthetic personnel certified by an accrediting organization 57 Individual prosthetic/orthotic personnel certified by an accrediting organization 58 Medical Supply Company with registered pharmacist 59 Ambulance Service Supplier, e.g., private ambulance companies, funeral homes 60 Public Health or Welfare Agencies (Federal, State, and local) 61 Voluntary Health or Charitable Agencies (e.g., National Cancer Society, National Heart Association, Catholic Charities) 62 Psychologist (Billing Independently) 63 Portable X-Ray Supplier (Billing Independently) 64 Audiologist (Billing Independently) 65 Physical Therapist in Private Practice 67 Occupational Therapist in Private Practice 68 Clinical Psychologist 69 Clinical Laboratory (Billing Independently) 71 Registered Dietician/Nutrition Professional 73 Mass Immunization Roster Billers (Mass Immunizers have to roster bill assigned claims and can only bill for immunizations) 74 Radiation Therapy Centers 75 Slide Preparation Facilities 80 Licensed Clinical Social Worker 87 All other suppliers, e.g., Drug Stores 88 Unknown Provider 89 Certified Clinical Nurse Specialist 95 Unknown Supplier 96 Optician Code Non-physician Practitioner/Supplier/Provider Specialty 97 Physician Assistant A0 Hospital A1 Skilled Nursing Facility A2 Intermediate Care Nursing Facility A3 Nursing Facility, Other A4 Home Health Agency A5 Pharmacy A6 Medical Supply Company with Respiratory Therapist A7 Department Store A8 Grocery Store B1 Oxygen/Oxygen Related Equipment B2 Pedorthic Personnel B3 Medical Supply Company with Pedorthic Personnel B4 Rehabilitation Agency B5 Ocularist C1 Centralized Flu C2 Indirect Payment Procedure C4 Restricted Use D1 Medicare Diabetes Preventive Program D2 Restricted Use D5 Opioid Treatment Program D6 Home Infusion Therapy Services NOTE: Specialty Code Use for Service in an Independent Laboratory. For services performed in an independent laboratory, show the specialty code of the physician ordering the x-rays and requesting payment. If the independent laboratory requests payment, use type of supplier code "69".