Provider Type and Provider Specialty

Master AppendixProvider Type and Provider Specialty Provider Type and Provider Specialty Wellmark BCBS July 24, 2006 types and Provider Specialties The Provider type indicates what kind of Provider is doing the billing. Provider types include individuals, facilities, and vendors. The Provider s Specialty is a value indicating what field of medicine a Provider has additional education in to make him/her a specialist in a certain field. NOTE: Provider type codes may not be unique to one Provider type. A good example is Provider type 20 says MD/DO but it is used on PHD, old social workers records and CRNA s and SD providers due to pricing issues. Be sure to look at the type in conjunction with the Specialty . Specialty Code Type Code Description Specialty Type 00 90 Any Specialty Miscellaneous 00 98 Any Specialty Out of country 00 99 Any Specialty Out of area 01 20/22 General Practice (MD/DO Occupational Medicine) Physician ( or )/Group Physician (Multiple Physician Practice) 02 20/22 General Surgery Physician ( or )/Group Physician (Multiple Physician Practice) 03 20/22 Allergy Physician ( or )/Group Physician (Multiple Physician Practice) 04 20/22 Otology, Laryngology, Rhinology (Otolaryngology) Physician ( or )/Group Physician (Multi)

Provider Type and Provider Specialty Provider Type and Provider Specialty Wellmark BCBS July 24, 2006 36.0 Provider Types and Provider Specialties The provider type indicates what “kind” of provider is doing the billing. Provider types include individuals, facilities, and

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