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IHCP Type and Specialty Matrix 032610 - Indiana Medicaid

www.indianamedicaid.com

Provider Type and Specialty Matrix IHCP Type and Specialty Matrix 032610.doc March 2010 2 Provider Type Code Provider Specialty Codes In-State Provider Requirements Out-of-State (OOS) Provider Requirements Provider Classifications and Additional Processing Information been approved as an LTAC by Medicare and have received a rate letter from

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PROVIDER TYPE CODE PROVIDER SPECIALTY

www.nd.gov

PROVIDER TYPE CODE PROVIDER SPECIALTY CODE TAXONOMY CODE ... 082-Home Health Agency 251E00000X 454- Hospice Care, Community Based 251G00000X 453-Human Service Center 251S00000X 397-Local Education Agency (LEA)/Special Education 251300000X 358-PACE 251T00000X 261-Public Health or Welfare 251K00000X

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PROVIDER TYPE CODE PROVIDER SPECIALTY CODE

www.nd.gov

173-Family Medicine 207Q00000X 302-Foot & Ankle Surgery 207XX0004X 010-Gastroenterology 207RG0100X 001-General Practice 208D00000X ... 126-Occupational Therapy 225X00000X 114-Orthotist 222Z00000X 123-Physical Therapist 225100000X 115-Prosthetist 224P00000X 349-Respiratory Therapist, Certified 227800000X ...

  Code, Types, Specialty, Occupational, Provider, Provider type code provider specialty

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