CMAC Class

'CMAC Class' ("CMAC for Class 01, 02, 03, or 04" on the screen) is the pricing cost based

on the class of provider:



Class 01 is the physician class, pertaining to Medical, MD, and DO’s (including clinical

lab procedures that are not Medical, MD, or DO related).

Class 02 is the psychologist class, pertaining to PHD’s and Psychologists.

Class 03 is other mental health providers.

Class 04 is extra medical provider (non-mental health only).









File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CMAC Class Page 1 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

101YA0400X Behavioral Health & Social Service DCP 074 Alcohol Abuse Counselor 3 Privileged

Providers/Counselor/Addiction (Substance Use

Disorder)

101YA0400X Behavioral Health & Social Service DCP 075 Drug Abuse Counselor 3 Privileged

Providers/Counselor/Addiction (Substance Use

Disorder)

101YM0800X Behavioral Health & Social Service 3

Providers/Counselor/Mental Health

101YP1600X Behavioral Health & Social Service TECH 530 Pastoral Counselor 4 Non-Priviliged

Providers/Counselor/Pastoral

101YP2500X Behavioral Health & Social Service 3

Providers/Counselor/Professional

101YS0200X Behavioral Health & Social Service 3

Providers/Counselor/School

103G00000X Behavioral Health & Social Service 2

Providers/Neuropsychologist

103GC0700X Behavioral Health & Social Service 2

Providers/Neuropsychologist/Clinical

103T00000X Behavioral Health & Social Service 2

Providers/Psychologist

103TA0400X Behavioral Health & Social Service 2

Providers/Psychologist/Addiction (Substance Use

Disorder)

103TA0700X Behavioral Health & Social Service 2

Providers/Psychologist/Adult Development &

Aging

103TB0200X Behavioral Health & Social Service 2

Providers/Psychologist/Behavioral

103TC0700X Behavioral Health & Social Service DCP 702 Clinical Psychologist 2 Privileged

Providers/Psychologist/Clinical

103TC1900X Behavioral Health & Social Service 2

Providers/Psychologist/Counseling

103TC2200X Behavioral Health & Social Service 2

Providers/Psychologist/Child, Youth & Family





File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 2 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

103TE1000X Behavioral Health & Social Service 2

Providers/Psychologist/Educational

103TE1100X Behavioral Health & Social Service 2

Providers/Psychologist/Exercise & Sports

103TF0000X Behavioral Health & Social Service 2

Providers/Psychologist/Family

103TF0200X Behavioral Health & Social Service 2

Providers/Psychologist/Forensic

103TH0100X Behavioral Health & Social Service 2

Providers/Psychologist/Health

103TM1700X Behavioral Health & Social Service 2

Providers/Psychologist/Men & Masculinity

103TM1800X Behavioral Health & Social Service 2

Providers/Psychologist/Mental Retardation &

Developmental Disabilities

103TP0814X Behavioral Health & Social Service DCP 072 Psychoanalyst 2 Privileged

Providers/Psychologist/Psychoanalysis

103TP2700X Behavioral Health & Social Service 2

Providers/Psychologist/Psychotherapy

103TP2701X Behavioral Health & Social Service 2

Providers/Psychologist/Psychotherapy, Group



103TR0400X Behavioral Health & Social Service 2

Providers/Psychologist/Rehabilitation

103TS0200X Behavioral Health & Social Service 2

Providers/Psychologist/School

103TW0100X Behavioral Health & Social Service 2

Providers/Psychologist/Women

104100000X Behavioral Health & Social Service DCP 703 Psychology Social 3 Privileged

Providers/Social Worker Worker

1041C0700X Behavioral Health & Social Service 3

Providers/Social Worker/Clinical

1041S0200X Behavioral Health & Social Service 3

Providers/Social Worker/School





File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 3 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

106H00000X Behavioral Health & Social Service 3

Providers/Marriage & Family Therapist

111N00000X Chiropractors/Chiropractor DCP 713 Chiropractor 4 Privileged

111NI0900X Chiropractors/Chiropractor/Internist 1

111NN0400X Chiropractors/Chiropractor/Neurology 1

111NN1001X Chiropractors/Chiropractor/Nutrition 1

111NR0200X Chiropractors/Chiropractor/Radiology 1

111NS0005X Chiropractors/Chiropractor/Sports Physician 1

111NT0100X Chiropractors/Chiropractor/Thermography 1

111NX0100X Chiropractors/Chiropractor/Occupational Medicine 1



111NX0800X Chiropractors/Chiropractor/Orthopedic 1

122300000X Dental Service Providers/Dentist DENT 812 Dental Officer General 1 Privileged

122300000X Dental Service Providers/Dentist DENT 813 Dental Officer Resident 1 Non Privileged -

with License with limitations

122300000X Dental Service Providers/Dentist DENT 811 Endodontic Resident with 1 Non Privileged -

License with limitations

122300000X Dental Service Providers/Dentist DENT 809 Oral Pathology Resident 1 Non Privileged -

with License with limitations

122300000X Dental Service Providers/Dentist DENT 816 Pedodontic Resident with 1 Non Privileged -

License with limitations

122300000X Dental Service Providers/Dentist DENT 803 Periodontic Resident with 1 Non Privileged -

License with limitations

122300000X Dental Service Providers/Dentist DENT 805 Prosthodontic Resident 1 Non Privileged -

with License with limitations

122300000X Dental Service Providers/Dentist DENT 801 Oral Surgery Resident 1 Non Privileged -

with License with limitations

122300000X Dental Service Providers/Dentist DENT 807 Orthodontic Resident with 1 Non Privileged -

License with limitations

1223P0300X Dental Service Providers/Dentist/Periodontics DENT 802 Periodontist 1 Privileged



1223P0700X Dental Service Providers/Dentist/Prosthodontics DENT 804 Prosthodontist 1 Privileged



1223S0112X Dental Service Providers/Dentist/Oral & DENT 800 Oral Surgeon 1 Privileged

Maxillofacial Surgery



File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 4 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

1223X0008X Dental Service Providers/Dentist/Oral & 1

Maxillofacial Radiology

1223X0400X Dental Service Providers/Dentist/Orthodontics & DENT 806 Orthodontist 1 Privileged

Dentofacial Orthopedics



122400000X Dental Service Providers/Denturist 4

124Q00000X Dental Service Providers/Dental Hygienist 4

126800000X Dental Service Providers/Dental Assistant TECH 902 Dental Assistant 4 Non-Privileged

126900000X Dental Service Providers/Dental Laboratory 4

Technician

132700000X Dietary & Nutritional Service Providers/Dietary 4

Manager

133N00000X Dietary & Nutritional Service Providers/Nutritionist DCP 704 Dietician-Nutritionist 4 Privileged



133NN1002X Dietary & Nutritional Service 4

Providers/Nutritionist/Nutrition, Education

133V00000X Dietary & Nutritional Service Providers/Dietician, 4

Registered

133VN1004X Dietary & Nutritional Service Providers/Dietician, 4

Registered/Nutrition, Pediatric



133VN1005X Dietary & Nutritional Service Providers/Dietician, 4

Registered/Nutrition, Renal



133VN1006X Dietary & Nutritional Service Providers/Dietician, 4

Registered/Nutrition, Metabolic



136A00000X Dietary & Nutritional Service Providers/Dietetic 4

Technician, Registered

146D00000X Emergency Medical Service Providers/Personal 4

Emergency Response Attendant



146L00000X Emergency Medical Service Providers/Emergency 4

Medical Technician, Paramedic





File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 5 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

146M00000X Emergency Medical Service Providers/Emergency 4

Medical Technician, Intermediate



146N00000X Emergency Medical Service Providers/Emergency 4

Medical Technician, Basic



152W00000X Eye and Vision Services Providers/Optometrist DCP 708 Optometrist 4 Privileged



152WC0802X Eye and Vision Services 4

Providers/Optometrist/Corneal and Contact

Management

152WL0500X Eye and Vision Services 4

Providers/Optometrist/Low Vision Rehabilitation



152WP0200X Eye and Vision Services 4

Providers/Optometrist/Pediatrics

152WS0006X Eye and Vision Services 4

Providers/Optometrist/Sports Vision

152WV0400X Eye and Vision Services 4

Providers/Optometrist/Vision Therapy

152WX0102X Eye and Vision Services 4

Providers/Optometrist/Occupational Vision

156F00000X Eye and Vision Services 4

Providers/Technician/Technologist

156FC0800X Eye and Vision Services 4

Providers/Technician/Technologist/Contact Lens



156FC0801X Eye and Vision Services 4

Providers/Technician/Technologist/Contact Lens

Fitter

156FX1100X Eye and Vision Services 4

Providers/Technician/Technologist/Ophthalmic









File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 6 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

156FX1101X Eye and Vision Services 4

Providers/Technician/Technologist/Ophthalmic

Assistant

156FX1201X Eye and Vision Services 4

Providers/Technician/Technologist/Optometric

Assistant

156FX1202X Eye and Vision Services 4

Providers/Technician/Technologist/Optometric

Technician

156FX1700X Eye and Vision Services 4

Providers/Technician/Technologist/Ocularist

156FX1800X Eye and Vision Services 4

Providers/Technician/Technologist/Optician

156FX1900X Eye and Vision Services 4

Providers/Technician/Technologist/Orthoptist



163W00000X Nursing Service Providers/Registered Nurse RN 600 Nurse, General Duty 4 Non-Privileged

163WA0400X Nursing Service Providers/Registered 3

Nurse/Addiction (Substance Use Disorder)

163WA2000X Nursing Service Providers/Registered 4

Nurse/Administrator

163WC0200X Nursing Service Providers/Registered 4

Nurse/Critical Care Medicine

163WC0400X Nursing Service Providers/Registered 4

Nurse/Case Management

163WC1400X Nursing Service Providers/Registered 4

Nurse/College Health

163WC1500X Nursing Service Providers/Registered RN 607 Community Health Nurse 4 Non-Privileged

Nurse/Community Health

163WC1600X Nursing Service Providers/Registered 4

Nurse/Continuing Education/Staff Development



163WC2100X Nursing Service Providers/Registered 4

Nurse/Continence Care





File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 7 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

163WC3500X Nursing Service Providers/Registered 4

Nurse/Cardiac Rehabilitation

163WD0400X Nursing Service Providers/Registered 4

Nurse/Diabetes Educator

163WD1100X Nursing Service Providers/Registered 4

Nurse/Dialysis, Peritoneal

163WE0003X Nursing Service Providers/Registered 4

Nurse/Emergency

163WE0900X Nursing Service Providers/Registered 4

Nurse/Enterostomal Therapy

163WF0300X Nursing Service Providers/Registered RN 606 Aerospace Nurse 4 Non-Privileged

Nurse/Flight

163WG0000X Nursing Service Providers/Registered 4

Nurse/General Practice

163WG0100X Nursing Service Providers/Registered 4

Nurse/Gastroenterology

163WG0600X Nursing Service Providers/Registered 4

Nurse/Gerontology

163WH0200X Nursing Service Providers/Registered 4

Nurse/Home Health

163WH0500X Nursing Service Providers/Registered 4

Nurse/Hemodialysis

163WH1000X Nursing Service Providers/Registered 4

Nurse/Hospice

163WI0500X Nursing Service Providers/Registered 4

Nurse/Infusion Therapy

163WI0600X Nursing Service Providers/Registered 4

Nurse/Infection Control

163WL0100X Nursing Service Providers/Registered 4

Nurse/Lactation Consultant

163WM0102X Nursing Service Providers/Registered 4

Nurse/Maternal Newborn

163WM0705X Nursing Service Providers/Registered 4

Nurse/Medical-Surgical





File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 8 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

163WM1400X Nursing Service Providers/Registered 4

Nurse/Massage Therapy

163WN0002X Nursing Service Providers/Registered 4

Nurse/Neonatal Intensive Care

163WN0003X Nursing Service Providers/Registered 4

Nurse/Neonatal, Low-Risk

163WN0300X Nursing Service Providers/Registered 4

Nurse/Nephrology

163WN0800X Nursing Service Providers/Registered 4

Nurse/Neuroscience

163WN1003X Nursing Service Providers/Registered 4

Nurse/Nutrition Support

163WP0000X Nursing Service Providers/Registered Nurse/Pain 4

Management

163WP0200X Nursing Service Providers/Registered 4

Nurse/Pediatrics

163WP0218X Nursing Service Providers/Registered 4

Nurse/Pediatrics, Pediatric Oncology

163WP0807X Nursing Service Providers/Registered 3

Nurse/Psychiatric/Mental Health, Child &

Adolescent

163WP0808X Nursing Service Providers/Registered RN 601 Mental Health Nurse 3 Non-Privileged

Nurse/ Psychiatric/Mental Health

163WP0809X Nursing Service Providers/Registered 3

Nurse/Psychiatric/Mental Health, Adult

163WP1700X Nursing Service Providers/Registered 4

Nurse/Perinatal

163WP2201X Nursing Service Providers/Registered 4

Nurse/Ambulatory Care

163WR0400X Nursing Service Providers/Registered 4

Nurse/Rehabilitation

163WR1000X Nursing Service Providers/Registered 4

Nurse/Reproductive Endocrinology/Infertility

163WS0121X Nursing Service Providers/Registered 4

Nurse/Plastic Surgery



File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 9 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

163WS0200X Nursing Service Providers/Registered 4

Nurse/School

163WU0100X Nursing Service Providers/Registered 4

Nurse/Urology

163WW0000X Nursing Service Providers/Registered 4

Nurse/Wound Care

163WW0101X Nursing Service Providers/Registered 4

Nurse/Women's Health Care, Ambulatory

163WX0002X Nursing Service Providers/Registered 4

Nurse/Obstetric, High-Risk

163WX0003X Nursing Service Providers/Registered 4

Nurse/Obstetric, Inpatient

163WX0106X Nursing Service Providers/Registered 4

Nurse/Occupational Health

163WX0200X Nursing Service Providers/Registered 4

Nurse/Oncology

163WX0601X Nursing Service Providers/Registered 4

Nurse/Otorhinolaryngology & Head-Neck

163WX0800X Nursing Service Providers/Registered 4

Nurse/Orthopedic

163WX1100X Nursing Service Providers/Registered 4

Nurse/Ophthalmic

163WX1500X Nursing Service Providers/Registered 4

Nurse/Ostomy Care

164W00000X Nursing Service Providers/Licensed Practical 4

Nurse

164X00000X Nursing Service Providers/Licensed Vocational 4

Nurse

167G00000X Licensed Psychiatric Technician 3

170100000X Other Service Providers/Medical Genetics: Ph.D. 2

Medical Genetics

4

170300000X Other Service Providers/Genetic Counselor, Ms

1710I1002X Military Health Care Provider/Independent TECH 520 Corpsman, Independent 4 Non-Privileged

Duty Corpsman (IDC) Duty



File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 10 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

1710I1003X Military Health Care Provider/Independent TECH 521 Technician, Independent 4 Non-Privileged

Duty Medical Technicians (IDMT) Duty Medical



171100000X Other Service Providers/Acupuncturist 4

171W00000X Other Service Providers/Contractor 4

171WH0202X Other Service Providers/Contractor/ Home 4

Modifications

171WV0202X Other Service Providers/Contractor/Vehicle 4

Modifications

172A00000X Other Service Providers/Driver 4

173000000X Other Service Providers/Legal Medicine 4

174400000X Other Service Providers/Specialist 4

1744G0900X Other Service Providers/Specialist/Graphics 4

Designer

1744P3200X Other Service Providers/Specialist/Prosthetics 4

Case Management



1744R1102X Other Service Providers/Specialist/Research DCP 701 Aerospace Physiologist 4 Privileged

Study

1744R1103X Other Service Providers/Specialist/Research Data 4

Abstracter/Coder

174M00000X Other Service Providers/Veterinarian 1

174MM1900X Other Service Providers/Veterinarian/Medical 1

Research

175F00000X Other Service Providers/Naturopath 4

175L00000X Other Service Providers/Homeopath 4

175M00000X Other Service Providers/Midwife, Lay 4

176B00000X Other Service Providers/Midwife, Certified 4

176P00000X Other Service Providers/Funeral Director 4

177F00000X Other Service Providers/Lodging 4

183500000X Pharmacy Service Providers/Pharmacist PHARM 750 Pharmacist, General 4 Privileged

Practice

1835G0000X Pharmacy Service Providers/Pharmacist/General 4

Practice





File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 11 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

1835N0905X Pharmacy Service Providers/Pharmacist/Nuclear 4

Pharmacy

1835N1003X Pharmacy Service Providers/Pharmacist/Nutrition 4

Support

1835P1200X Pharmacy Service PHARM 202 Medical Chemist 4 Privileged

Providers/Pharmacist/Pharmacotherapy

1835P1300X Pharmacy Service 4

Providers/Pharmacist/Psychopharmacy

183700000X Pharmacy Service Providers/Pharmacy 4

Technician

204C00000X Physicians/Allopathic/Osteopathic/Neuromusculo 1

skeletal Medicine/Sports Medicine

204D00000X Physicians/Allopathic/Osteopathic/Neuromusculo 1

skeletal Medicine & OMM

204E00000X Physicians/Allopathic/Osteopathic/Oral & 1

Maxillofacial Surgery

204F00000X Physicians/Allopathic/Osteopathic/Surgery/Transp 1

lant Surgery

207K00000X Physicians/Allopathic/Osteopathic/Allergy & 1

Immunology

207KA0200X Physicians/Allopathic/Osteopathic/Allergy & PHYS 012 Allergist/Immunologist 1 Privileged

Immunology/Allergy

207KI0005X Physicians/Allopathic/Osteopathic/Allergy & 1

Immunology/Clinical & Laboratory Immunology



207L00000X Physicians/Allopathic/Osteopathic/Anesthesiology PHYS 092 Anesthesiologist 1 Privileged



207LA0401X Physicians/Allopathic/Osteopathic/Anesthesiology 1

/Addiction Medicine

207LC0200X Physicians/Allopathic/Osteopathic/Anesthesiology 1

/Critical Care Medicine

207LP2900X Physicians/Allopathic/Osteopathic/Anesthesiology 1

/Pain Medicine

207N00000X Physicians/Allopathic/Osteopathic/Dermatology PHYS 080 Dermatologist 1 Privileged





File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 12 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

207ND0101X Physicians/Allopathic/Osteopathic/Dermatology/M 1

OHS-Micrographic Surgery

207ND0900X Physicians/Allopathic/Osteopathic/Dermatology/D PHYS 085 Physician/Dermatology/D 1 Privileged

ermatopathology ermatopathology

207NI0002X Physicians/Allopathic/Osteopathic/Dermatology/Cl PHYS 083 Physician/Dermatology/Cl 1 Privileged

inical & Laboratory Dermatological Immunology inical & Laboratory

Immunology

207NP0225X Physicians/Allopathic/Osteopathic/Dermatology/P PHYS 044 Dermatologist, Pediatric 1 Privileged

ediatric Dermatology

207NS0135X Physicians/Allopathic/Osteopathic/Dermatology/D PHYS 084 Physician/Dermatology/D 1 Privileged

ermatological Surgery ermatological Surgery

207P00000X Physicians/Allopathic/Osteopathic/Emergency PHYS 004 Emergency Physician 1 Privileged

Medicine

207PE0004X Physicians/Allopathic/Osteopathic/Emergency PHYS 089 Emergency 1 Privileged

Medicine/Emergency Medical Services Physician/Emergency

Medical Services

207PE0005X Physicians/Allopathic/Osteopathic/Emergency 1

Medicine/Undersea & Hyperbaric Medicine

207PP0204X Physicians/Allopathic/Osteopathic/Emergency PHYS 087 Emergency 1 Privileged

Medicine/Pediatric Emergency Medicine Physician/Pediatric

Emergency Medicine

207PS0010X Physicians/Allopathic/Osteopathic/Emergency PHYS 088 Emergency 1 Privileged

Medicine/Sports Medicine Physician/Sports

Medicine

207PT0002X Physicians/Allopathic/Osteopathic/Emergency PHYS 086 Emergency Physician / 1 Privileged

Medicine/Medical Toxicology Medical Toxicology

207Q00000X Physicians/Allopathic/Osteopathic/Family Practice PHYS 001 Family Practice Physician 1 Privileged



207QA0000X Physicians/Allopathic/Osteopathic/Family 1

Practice/Adolescent Medicine

207QA0401X Physicians/Allopathic/Osteopathic/Family 1

Practice/Addiction Medicine

207QA0505X Physicians/Allopathic/Osteopathic/Family 1

Practice/Adult Medicine





File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 13 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

207QG0300X Physicians/Allopathic/Osteopathic/Family 1

Practice/Geriatric Medicine

207QS0010X Physicians/Allopathic/Osteopathic/Family 1

Practice/Sports Medicine

207R00000X Physicians/Allopathic/Osteopathic/Internal PHYS 011 Internist 1 Privileged

Medicine

207R10008X Physicians/Allopathic/Osteopathic/Internal 1

Medicine/Hepatology

207RA0000X Physicians/Allopathic/Osteopathic/Internal 1

Medicine/Adolescent Medicine

207RA0201X Physicians/Allopathic/Osteopathic/Internal 1

Medicine/Allergy & Immunology

207RA0401X Physicians/Allopathic/Osteopathic/Internal 1

Medicine/Addiction Medicine

207RC0000X Physicians/Allopathic/Osteopathic/Internal PHYS 014 Cardiologist 1 Privileged

Medicine/Cardiovascular Disease

207RC0000X Physicians/Allopathic/Osteopathic/Internal PHYS 015 Cardiopulmonary 1 Privileged

Medicine/Cardiovascular Disease Laboratory Physician

207RC0001X Physicians/Allopathic/Osteopathic/Internal PHYS 008 Internal Medicine 1 Privileged

Medicine/Clinical Cardiac Electrophysiology Physician/Clinical Cardiac

Electrophysiology



207RC0200X Physicians/Allopathic/Osteopathic/Internal PHYS 097 Internal Medicine 1 Privileged

Medicine/Critical Care Medicine Physician/Critical Care

Medicine

207RE0101X Physicians/Allopathic/Osteopathic/Internal PHYS 016 Endocrinologist 1 Privileged

Medicine/Endocrinology/Diabetes & Metabolism



207RE0101X Physicians/Allopathic/Osteopathic/Internal PHYS 023 Metabolic Diseases, 1 Privileged

Medicine/Endocrinology/Diabetes & Metabolism Physician



207RG0100X Physicians/Allopathic/Osteopathic/Internal PHYS 018 Gastroenterologist 1 Privileged

Medicine/Gastroenterology

207RG0300X Physicians/Allopathic/Osteopathic/Internal PHYS 017 Geriatrician 1 Privileged

Medicine/Geriatric Medicine



File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 14 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

207RH0000X Physicians/Allopathic/Osteopathic/Internal PHYS 019 Hematologist 1 Privileged

Medicine/Hematology

207RH0003X Physicians/Allopathic/Osteopathic/Internal 1

Medicine/Hematology & Oncology

207RI0001X Physicians/Allopathic/Osteopathic/Internal 1

Medicine/Clinical & Laboratory Immunology

207RI0011X Physicians/Allopathic/Osteopathic/Internal PHYS 098 Internal Medicine 1 Privileged

Medicine/Interventional Cardiology Physician/Interventional

Cardiology

207RI0200X Physicians/Allopathic/Osteopathic/Internal PHYS 022 Infectious Disease 1 Privileged

Medicine/Infectious Disease Physician

207RM1200X Physicians/Allopathic/Osteopathic/Internal 1

Medicine/Magnetic Resonance Imaging (MRI)



207RN0300X Physicians/Allopathic/Osteopathic/Internal PHYS 024 Nephrologist 1 Privileged

Medicine/Nephrology

207RP1001X Physicians/Allopathic/Osteopathic/Internal PHYS 021 Pulmonary Disease 1 Privileged

Medicine/Pulmonary Disease Physician

207RR0500X Physicians/Allopathic/Osteopathic/Internal PHYS 020 Rheumatologist 1 Privileged

Medicine/Rheumatology

207RS0010X Physicians/Allopathic/Osteopathic/Internal PHYS 099 Internal Medicine 1 Privileged

Medicine/Sports Medicine Physician/Sport Medicine



207RX0202X Physicians/Allopathic/Osteopathic/Internal PHYS 013 Oncologist 1 Privileged

Medicine/Medical Oncology

207SC0300X Physicians/Allopathic/Osteopathic/Medical 1

Genetics/Clinical Cytogenetics

207SG0201X Physicians/Allopathic/Osteopathic/Medical PHYS 025 Medical Geneticist 1 Privileged

Genetics/Clinical Genetics (M.D.)

207SG0202X Physicians/Allopathic/Osteopathic/Medical 1

Genetics/Clinical Biochemical Genetics

207SG0203X Physicians/Allopathic/Osteopathic/Medical 1

Genetics/Clinical Molecular Genetics

207SG0205X Physicians/Allopathic/Osteopathic/Medical 1

Genetics/Ph.D. Medical Genetics



File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 15 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

207SM0001X Physicians/Allopathic/Osteopathic/Medical 1

Genetics/Molecular Genetic Pathology

207T00000X Physicians/Allopathic/Osteopathic/Neurological PHYS 106 Neurosurgeon 1 Privileged

Surgery

207U00000X Physicians/Allopathic/Osteopathic/Nuclear PHYS 027 Nuclear Medicine 1 Privileged

Medicine Physician

207U00000X Physicians/Allopathic/Osteopathic/Nuclear PHYS 206 Nuclear Medicine 1 Privileged

Medicine Pathologist

207UN0901X Physicians/Allopathic/Osteopathic/Nuclear 1

Medicine/Nuclear Cardiology

207UN0902X Physicians/Allopathic/Osteopathic/Nuclear 1

Medicine/Nuclear Imaging & Therapy

207UN0903X Physicians/Allopathic/Osteopathic/Nuclear 1

Medicine/In Vivo & In Vitro Nuclear Medicine

207V00000X Physicians/Allopathic/Osteopathic/Obstetrics & PHYS 150 Obstetrician & 1 Privileged

Gynecology Gynecologist

207VC0200X Physicians/Allopathic/Osteopathic/Obstetrics & PHYS 156 Physician/Obstetrics & 1 Privileged

Gynecology/Critical Care Medicine Gynecology/Critical Care

Medicine

207VE0102X Physicians/Allopathic/Osteopathic/Obstetrics & PHYS 151 Endocrinologist, OB/GYN 1 Privileged

Gynecology/Reproductive Endocrinology

207VG0400X Physicians/Allopathic/Osteopathic/Obstetrics & PHYS 157 Physician/Obstetrics & 1 Privileged

Gynecology/Gynecology Gynecology/Gynecology

207VM0101X Physicians/Allopathic/Osteopathic/Obstetrics & 1

Gynecology/Maternal & Fetal Medicine

207VX0000X Physicians/Allopathic/Osteopathic/Obstetrics & 1

Gynecology/Obstetrics

207VX0201X Physicians/Allopathic/Osteopathic/Obstetrics & PHYS 152 Oncologist OB/GYN 1 Privileged

Gynecology/Gynecologic Oncology

207W00000X Physicians/Allopathic/Osteopathic/Ophthalmology PHYS 120 Ophthalmologist 1 Privileged



207X00000X Physicians/Allopathic/Osteopathic/Orthopaedic PHYS 140 Orthopedic Surgeon 1 Privileged

Surgery

207XS0106X Physicians/Allopathic/Osteopathic/Orthopaedic PHYS 145 Physicians/Orthopaedic 1 Privileged

Surgery/Hand Surgery Surgery/Hand Surgery



File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 16 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

207XS0114X Physicians/Allopathic/Osteopathic/Orthopaedic 1

Surgery/Adult Reconstructive Orthopaedic

Surgery

207XS0117X Physicians/Allopathic/Osteopathic/Orthopaedic PHYS 146 Physicians/Orthopaedic 1 Privileged

Surgery/Orthopaedic Surgery of the Spine Surgery/Orthopaedic

Surgery of the Spine

207XX0004X Physicians/Allopathic/Osteopathic/Orthopaedic PHYS 144 Physicians/Orthopaedic 1 Privileged

Surgery/Foot and Ankle Orthopaedics Surgery/Foot and Ankle

Orthopaedics

207XX0005X Physicians/Allopathic/Osteopathic/Orthopaedic PHYS 148 Physicians/Orthopaedic 1 Privileged

Surgery/Sports Medicine Surgery/Sports Medicine



207XX0801X Physicians/Allopathic/Osteopathic/Orthopaedic PHYS 147 Physicians/Orthopaedic 1 Privileged

Surgery/Orthopaedic Trauma Surgery/Orthopaedic

Trauma

207Y00000X Physicians/Allopathic/Osteopathic/Otolaryngology PHYS 130 Otolaryngologist 1 Privileged



207YP0228X Physicians/Allopathic/Osteopathic/Otolaryngology PHYS 135 Physicians/Otolaryngolog 1 Privileged

/Pediatric Otolaryngology y/Pediatric Otolaryngology



207YS0123X Physicians/Allopathic/Osteopathic/Otolaryngology PHYS 133 Physicians/Otolaryngolog 1 Privileged

/Facial Plastic Surgery y/Facial Plastic Surgery



207YX0007X Physicians/Allopathic/Osteopathic/Otolaryngology PHYS 136 Physicians/Otolaryngolog 1 Privileged

/Plastic Surgery within the Head & Neck y/Plastic Surgery within

the Head & Neck

207YX0602X Physicians/Allopathic/Osteopathic/Otolaryngology 1

/Otolaryngic Allergy

207YX0901X Physicians/Allopathic/Osteopathic/Otolaryngology PHYS 134 Physicians/Otolaryngolog 1 Privileged

/Otology & Neurotology y/Otology & Neurotology



207YX0905X Physicians/Allopathic/Osteopathic/Otolaryngology 1

/Facial Plastic Surgery









File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 17 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

207ZB0001X Physicians/Allopathic/Osteopathic/Pathology/Bloo PHYS 223 Physicians/Pathology/Blo 1 Privileged

d Banking & Transfusion Medicine od Banking & Transfusion

Medicine

207ZC0500X Physicians/Allopathic/Osteopathic/Pathology/Path PHYS 225 Physicians/Pathology/Pat 1 Privileged

ology & Cytopathology hology & Cytopathology



207ZD0900X Physicians/Allopathic/Osteopathic/Pathology/Der PHYS 226 Physicians/Allopathic/Ost 1 Privileged

matopathology eopathic/Pathology/Derm

atopathology

207ZF0201X Physicians/Allopathic/Osteopathic/Pathology/Fore PHYS 204 Pathologist, Forensic 1 Privileged

nsic Pathology

207ZH0000X Physicians/Allopathic/Osteopathic/Pathology/Hem PHYS 227 Physicians/Pathology/He 1 Privileged

atology matology

207ZI0100X Physicians/Allopathic/Osteopathic/Pathology/Imm PHYS 228 Physicians/Pathology/Im 1 Privileged

unopathology munopathology

207ZM0300X Physicians/Allopathic/Osteopathic/Pathology/Medi 1

cal Microbiology

207ZN0500X Physicians/Allopathic/Osteopathic/Pathology/Neur PHYS 205 Neuropathologist 1 Privileged

opathology

207ZP0007X Physicians/Allopathic/Osteopathic/Pathology/Mole 1

cular Genetic Pathology

207ZP0101X Physicians/Allopathic/Osteopathic/Pathology/Anat PHYS 221 Physicians/Pathology/Ana 1 Privileged

omic Pathology tomic Pathology

207ZP0102X Physicians/Allopathic/Osteopathic/Pathology/Anat PHYS 153 Pathologist, OB/GYN 1 Privileged

omic Pathology & Clinical Pathology

207ZP0102X Physicians/Allopathic/Osteopathic/Pathology/Anat PHYS 222 Physicians/Pathology/Ana 1 Privileged

omic Pathology & Clinical Pathology tomic Pathology & Clinical

Pathology

207ZP0104X Physicians/Allopathic/Osteopathic/Pathology/Che PHYS 224 Physicians/Pathology/Che 1 Privileged

mical Pathology mical Pathology

207ZP0105X Physicians/Allopathic/Osteopathic/Pathology/Clini PHYS 200 Pathologist 1 Privileged

cal Pathology/Laboratory Medicine

207ZP0213X Physicians/Allopathic/Osteopathic/Pathology/Pedi 1

atric Pathology

208000000X Physicians/Allopathic/Osteopathic/Pediatrics PHYS 040 Pediatrician 1 Privileged



File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 18 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

2080A0000X Physicians/Allopathic/Osteopathic/Pediatrics/Adol PHYS 042 Adolescent Medicine 1 Privileged

escent Medicine Physician

2080I0007X Physicians/Allopathic/Osteopathic/Pediatrics/Clini 1

cal & Laboratory Immunology

2080N0001X Physicians/Allopathic/Osteopathic/Pediatrics/Neo PHYS 046 Neonatalogist- 1 Privileged

natal-Perinatal Medicine Perinatologist

2080P0006X Physicians/Allopathic/Osteopathic/Pediatrics/Dev PHYS 033 Physicians/Pediatrics/Dev 1 Privileged

elopmental-Behavioral Pediatrics elopmental-Behavioral

Pediatrics

2080P0008X Physicians/Allopathic/Osteopathic/Pediatrics/Neur 1

odevelopmental Disabilities

2080P0201X Physicians/Allopathic/Osteopathic/Pediatrics/Pedi PHYS 041 Allergist, Pediatric 1 Privileged

atric Allergy & Immunology

2080P0202X Physicians/Allopathic/Osteopathic/Pediatrics/Pedi PHYS 043 Cardiologist, Pediatric 1 Privileged

atric Cardiology

2080P0203X Physicians/Allopathic/Osteopathic/Pediatrics/Pedi PHYS 035 Physicians/Pediatrics/Ped 1 Privileged

atric Critical Care Medicine iatric Critical Care

Medicine

2080P0204X Physicians/Allopathic/Osteopathic/Pediatrics/Pedi PHYS 036 Physicians/Pediatrics/Ped 1 Privileged

atric Emergency Medicine iatric Emergency

Medicine

2080P0205X Physicians/Allopathic/Osteopathic/Pediatrics/Pedi PHYS 045 Endocrinologist, Pediatric 1 Privileged

atric Endocrinology

2080P0205X Physicians/Allopathic/Osteopathic/Pediatrics/Pedi PHYS 047 Metabolic Diseases, 1 Privileged

atric Endocrinology Physician, Pediatrics

2080P0206X Physicians/Allopathic/Osteopathic/Pediatrics/Pedi PHYS 053 Gastroenterologist, 1 Privileged

atric Gastroenterology Pediatric

2080P0207X Physicians/Allopathic/Osteopathic/Pediatrics/Pedi PHYS 048 Hematologist, Pediatric 1 Privileged

atric Hematology-Oncology

2080P0208X Physicians/Allopathic/Osteopathic/Pediatrics/Pedi PHYS 051 Infectious Diseases 1 Privileged

atric Infectious Diseases Physician, Pediatric

2080P0210X Physicians/Allopathic/Osteopathic/Pediatrics/Pedi PHYS 054 Nephrologist, Pediatric 1 Privileged

atric Nephrology

2080P0214X Physicians/Allopathic/Osteopathic/Pediatrics/Pedi PHYS 050 Pulmonary Disease 1 Privileged

atric Pulmonology Physician, Pediatric



File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 19 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

2080P0216X Physicians/Allopathic/Osteopathic/Pediatrics/Pedi PHYS 037 Physicians/Pediatrics/Ped 1 Privileged

atric Rheumatology iatric Rheumatology

2080S0010X Physicians/Allopathic/Osteopathic/Pediatrics/Spor 1

ts Medicine

2080T0002X Physicians/Allopathic/Osteopathic/Pediatrics/Medi PHYS 034 Physicians/Pediatrics/Me 1 Privileged

cal Toxicology dical Toxicology

208100000X Physicians/Allopathic/Osteopathic/Physical PHYS 090 Physical Medicine 1 Privileged

Medicine & Rehabilitation Physician

2081P0004X Physicians/Allopathic/Osteopathic/Physical PHYS 096 Physicians/Physical 1 Privileged

Medicine & Rehabilitation/Spinal Cord Injury Medicine &

Medicine Rehabilitation/Spinal Cord

Injury Medicine

2081P0010X Physicians/Allopathic/Osteopathic/Physical 1

Medicine & Rehabilitation/Pediatric Rehabilitation

Medicine

2081P2900X Physicians/Allopathic/Osteopathic/Physical 1

Medicine & Rehabilitation/Pain Medicine

2081S0010X Physicians/Allopathic/Osteopathic/Physical 1

Medicine & Rehabilitation/Sports Medicine

208200000X Physicians/Allopathic/Osteopathic/Plastic Surgery PHYS 107 Plastic Surgeon 1 Privileged



2082S0099X Physicians/Allopathic/Osteopathic/Plastic 1

Surgery/Plastic Surgery within the Head and Neck



2082S0105X Physicians/Allopathic/Osteopathic/Plastic 1

Surgery/Surgery of the Hand

2083A0100X Physicians/Allopathic/Osteopathic/Preventive & PHYS 300 Aerospace Medicine 1 Privileged

Occupational Medicine/Aerospace Medicine Physician



2083A0100X Physicians/Allopathic/Osteopathic/Preventive & PHYS 302 Aerospace Medicine 1 Privileged

Occupational Medicine/Aerospace Medicine Flight Surgeon/Family

Practice Physician

2083P0011X Physicians/Allopathic/Osteopathic/Preventive & PHYS 322 Hyperbaric/Undersea 1 Privileged

Occupational Medicine/Preventive Physician

Medicine/Undersea and Hyperbaric Medicine



File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 20 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

2083P0500X Physicians/Allopathic/Osteopathic/Preventive & PHYS 091 Special Weapons 1 Privileged

Occupational Medicine/Preventive Defense Physician

Medicine/Occupational Environmental Medicine



2083P0901X Physicians/Allopathic/Osteopathic/Preventive & PHYS 026 Tropical Medicine 1 Privileged

Occupational Medicine/Public Health & General Physician

Preventive Medicine

2083P0901X Physicians/Allopathic/Osteopathic/Preventive & PHYS 325 Physicians/Preventive & 1 Privileged

Occupational Medicine/Public Health & General Occupational

Preventive Medicine Medicine/Public Health &

General Preventive

Medicine

2083T0002X Physicians/Allopathic/Osteopathic/Preventive & PHYS 324 Physicians/Preventive & 1 Privileged

Occupational Medicine/Preventive Occupational

Medicine/Medical Toxicology Medicine/Preventive

Medicine/Medical

Toxicology

2083X0100X Physicians/Allopathic/Osteopathic/Preventive & PHYS 321 Occupational Medicine 1 Privileged

Occupational Medicine/Occupational Medicine Physician



2084A0401X Physicians/Allopathic/Osteopathic/Psychiatry & 1

Neurology/Addiction Medicine

2084F0202X Physicians/Allopathic/Osteopathic/Psychiatry & 1

Neurology/Forensic Psychiatry

2084N0400X Physicians/Allopathic/Osteopathic/Psychiatry & PHYS 060 Neurologist 1 Privileged

Neurology/Neurology

2084N0402X Physicians/Allopathic/Osteopathic/Psychiatry & PHYS 049 Neurologist, Pediatrics 1 Privileged

Neurology/Neurology with Special Qualifications

in Child Neurology

2084N0600X Physicians/Allopathic/Osteopathic/Psychiatry & 1

Neurology/Clinical Neurophysiology

2084P0005X Physicians/Allopathic/Osteopathic/Psychiatry & 1

Neurology/Neurodevelopmental Disabilities









File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 21 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

2084P0800X Physicians/Allopathic/Osteopathic/Psychiatry & PHYS 070 Psychiatrist 1 Privileged

Neurology/Psychiatry

2084P0802X Physicians/Allopathic/Osteopathic/Psychiatry & PHYS 076 Physicians/Psychiatry & 1 Privileged

Neurology/Addiction Psychiatry Neurology/Addiction

Psychiatry

2084P0804X Physicians/Allopathic/Osteopathic/Psychiatry & PHYS 071 Child Psychiatrist 1 Privileged

Neurology/Child & Adolescent Psychiatry

2084P0805X Physicians/Allopathic/Osteopathic/Psychiatry & 1

Neurology/Geriatric Psychiatry

2084P2900X Physicians/Allopathic/Osteopathic/Psychiatry & 1

Neurology/Pain Medicine

2084S0010X Physicians/Allopathic/Osteopathic/Psychiatry & 1

Neurology/Sports Medicine

2084V0102X Physicians/Allopathic/Osteopathic/Psychiatry & 1

Neurology/Vascular Neurology

2085B0100X Physicians/Allopathic/Osteopathic/Radiology/Bod PHYS 400 Radiologist 1 Privileged

y Imaging

2085N0700X Physicians/Allopathic/Osteopathic/Radiology/Neur PHYS 402 Neuro-Radiologist 1 Privileged

oradiology

2085N0904X Physicians/Allopathic/Osteopathic/Radiology/Nucl PHYS 403 Nuclear Medicine 1 Privileged

ear Radiology Radiologist

2085P0229X Physicians/Allopathic/Osteopathic/Radiology/Pedi PHYS 410 Physicians/Radiology/Ped 1 Privileged

atrics/Pediatric Radiology iatrics/Pediatric Radiology



2085R0001X Physicians/Allopathic/Osteopathic/Radiology/Radi PHYS 411 Physicians/Radiology/Rad 1 Privileged

ation Oncology iation Oncology

2085R0202X Physicians/Allopathic/Osteopathic/Radiology/Diag PHYS 404 Diagnostic Radiologist 1 Privileged

nostic Radiology

2085R0203X Physicians/Allopathic/Osteopathic/Radiology/Ther PHYS 401 Radiation Therapist 1 Privileged

apeutic Radiology

2085R0204X Physicians/Allopathic/Osteopathic/Radiology/Vas PHYS 405 Special Procedures 1 Privileged

cular & Interventional Radiology Radiologist

2085R0205X Physicians/Allopathic/Osteopathic/Radiology/Radi PHYS 407 Radiophysicist 1 Privileged

ological Physics





File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 22 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

2085U0001X Physicians/Allopathic/Osteopathic/Radiology/Diag 1

nostic Ultrasound

208600000X Physicians/Allopathic/Osteopathic/Surgery PHYS 100 General Surgeon 1 Privileged

2086S0102X Physicians/Allopathic/Osteopathic/Surgery/Surgic 1

al Critical Care

2086S0105X Physicians/Allopathic/Osteopathic/Surgery/Surger PHYS 141 Hand Surgeon 1 Privileged

y of the Hand

2086S0120X Physicians/Allopathic/Osteopathic/Surgery/Pediat PHYS 104 Pediatric Surgeon 1 Privileged

ric Surgery

2086S0122X Physicians/Allopathic/Osteopathic/Surgery/Plastic 1

& Reconstructive Surgery

2086S0127X Physicians/Allopathic/Osteopathic/Surgery/Traum 1

a Surgery

2086S0129X Physicians/Allopathic/Osteopathic/Surgery/Vascul PHYS 103 Cardiac Surgeon 1 Privileged

ar Surgery

2086S0129X Physicians/Allopathic/Osteopathic/Surgery/Vascul PHYS 105 Peripheral Vascular 1 Privileged

ar Surgery Surgeon

2086X0206X Physicians/Allopathic/Osteopathic/Surgery/Surgic 1

al Oncology

208800000X Physicians/Allopathic/Osteopathic/Urology PHYS 110 Urologist 1 Privileged

208C00000X Physicians/Allopathic/Osteopathic/Colon & Rectal PHYS 102 Colon & Rectal Surgeon 1 Privileged

Surgery

208D00000X Physicians/Allopathic/Osteopathic/General PHYS 000 General Practice 1 Privileged

Practice Physician

208D00000X Physicians/Allopathic/Osteopathic/General PHYS Family Practice 1 Privileged

Practice Physician

Resident/Intern With

003 License

208D00000X Physicians/Allopathic/Osteopathic/General PHYS Emergency Physician 1 Privileged

Practice Resident/Intern With

005 License

208D00000X Physicians/Allopathic/Osteopathic/General PHYS Internal Medicine 1 Privileged

Practice Resident/Intern With

028 License



File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 23 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

208D00000X Physicians/Allopathic/Osteopathic/General PHYS Pediatric 1 Privileged

Practice Resident/Intern With

052 License

208D00000X Physicians/Allopathic/Osteopathic/General PHYS Neurologist 1 Privileged

Practice Resident/Intern With

061 License

208D00000X Physicians/Allopathic/Osteopathic/General PHYS Psychiatric 1 Privileged

Practice Resident/Intern With

073 License

208D00000X Physicians/Allopathic/Osteopathic/General PHYS Dermatologist 1 Privileged

Practice Resident/Intern With

081 License

208D00000X Physicians/Allopathic/Osteopathic/General PHYS Anesthesiology 1 Privileged

Practice Resident/Intern With

093 License

208D00000X Physicians/Allopathic/Osteopathic/General PHYS SURGERY 1 Privileged

Practice RESIDENT/INTERN

108 WITH LICENSE

208D00000X Physicians/Allopathic/Osteopathic/General PHYS Urology 1 Privileged

Practice Resident/Intern With

111 License

208D00000X Physicians/Allopathic/Osteopathic/General PHYS Plastic Surgery 1 Privileged

Practice Resident/Intern With

115 License

208D00000X Physicians/Allopathic/Osteopathic/General PHYS Ophthalmology 1 Privileged

Practice Resident/Intern With

121 License

208D00000X Physicians/Allopathic/Osteopathic/General PHYS Otorhinolaryngology 1 Privileged

Practice Resident/Intern With

131 License









File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 24 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

208D00000X Physicians/Allopathic/Osteopathic/General PHYS Orthopedic 1 Privileged

Practice Resident/Intern With

142 License

208D00000X Physicians/Allopathic/Osteopathic/General PHYS Ob/Gyn 1 Privileged

Practice Resident/Intern With

154 License

208D00000X Physicians/Allopathic/Osteopathic/General PHYS Pathology 1 Privileged

Practice Resident/Intern With

207 License

208D00000X Physicians/Allopathic/Osteopathic/General PHYS Aerospace Medicine 1 Privileged

Practice Resident/Intern With

301 License

208D00000X Physicians/Allopathic/Osteopathic/General PHYS Radiology 1 Privileged

Practice Resident/Intern With

406 License

208M00000X Physicians/Allopathic/Osteopathic/Hospitalist 1



208U00000X Physicians/Allopathic/Osteopathic/Clinical 1

Pharmacology

208VP0000X Physicians/Allopathic/Osteopathic/Pain 1

Medicine/Pain Management

208VP0014X Physicians/Allopathic/Osteopathic/Pain 1

Medicine/Interventional Pain Management

209800000X Physicians/Allopathic/Osteopathic/Legal Medicine 1



211D00000X Podiatric Medicine & Surgery Service 4

ProvidersAssistant, Podiatric

213E00000X Podiatric Medicine & Surgery Service DCP 707 Podiatrist 1 Privileged

Providers/Podiatrist

213EG0000X Podiatric Medicine & Surgery Service 1

Providers/Podiatrist/General Practice

213EP0504X Podiatric Medicine & Surgery Service 1

Providers/Podiatrist/Public Health





File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 25 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

213EP1101X Podiatric Medicine & Surgery Service 1

Providers/Podiatrist/Primary Podiatric Medicine



213ER0200X Podiatric Medicine & Surgery Service 1

Providers/Podiatrist/Radiology

213ES0000X Podiatric Medicine & Surgery Service 1

Providers/Podiatrist/Sports Medicine

213ES0103X Podiatric Medicine & Surgery Service 1

Providers/Podiatrist/Surgery/ Foot & Ankle

213ES0131X Podiatric Medicine & Surgery Service 1

Providers/Podiatrist/Surgery/Foot

221700000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Art Therapist

222Z00000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Orthotist

224P00000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Prosthetist

224Z00000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Occupational Therapy Assistant



225000000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Orthotics/Prosthetics Fitter

225100000X Respiratory, Rehabilitative & Restorative Service DCP 706 Physical Therapist 4 Privileged

Providers/Physical Therapist

2251C2600X Respiratory, Rehabilitative & Restorative Service 4

Providers/Physical Therapist/Cardiopulmonary



2251E1200X Respiratory, Rehabilitative & Restorative Service 4

Providers/Physical Therapist/Ergonomics



2251E1300X Respiratory, Rehabilitative & Restorative Service 4

Providers/Physical Therapist/Electrophysiology,

Clinical









File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 26 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

2251G0304X Respiratory, Rehabilitative & Restorative Service 4

Providers/Physical Therapist/Geriatrics



2251H1200X Respiratory, Rehabilitative & Restorative Service 4

Providers/Physical Therapist/Hand

2251H1300X Respiratory, Rehabilitative & Restorative Service 4

Providers/Physical Therapist/Human Factors



2251N0400X Respiratory, Rehabilitative & Restorative Service 4

Providers/Physical Therapist/Neurology



2251P0200X Respiratory, Rehabilitative & Restorative Service 4

Providers/Physical Therapist/Pediatrics



2251S0007X Respiratory, Rehabilitative & Restorative Service 4

Providers/Physical Therapist/Sports

2251X0800X Respiratory, Rehabilitative & Restorative Service 4

Providers/Physical Therapist/Orthopedic



225200000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Physical Therapy Assistant



225400000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Rehabilitation Practitioner

225500000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Specialist/Technologist

2255A2300X Respiratory, Rehabilitative & Restorative Service 4

Providers/Specialist/Technologist/Athletic Trainer





2255R0406X Respiratory, Rehabilitative & Restorative Service 4

Providers/Specialist/Technologist/Rehabilitation,

Blind









File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 27 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

225600000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Dance Therapist

225700000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Massage Therapist

225800000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Recreation Therapist

225A00000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Music Therapist

225B00000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Pulmonary Function Technologist



225C00000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Rehabilitation Counselor

225CA2400X Respiratory, Rehabilitative & Restorative Service 4

Providers/Rehabilitation Counselor/Assistive

Technology Practitioner

225CA2500X Respiratory, Rehabilitative & Restorative Service 4

Providers/Rehabilitation Counselor/Assistive

Technology Supplier

225X00000X Respiratory, Rehabilitative & Restorative Service DCP 705 Occupational Therapist 4 Privileged

Providers/Occupational Therapist

225XE1200X Respiratory, Rehabilitative & Restorative Service 4

Providers/Occupational Therapist/ Ergonomics



225XH1200X Respiratory, Rehabilitative & Restorative Service 4

Providers/Occupational Therapist/ Hand



225XH1300X Respiratory, Rehabilitative & Restorative Service 4

Providers/Occupational Therapist/ Human

Factors

225XN1300X Respiratory, Rehabilitative & Restorative Service 4

Providers/Occupational

Therapist/Neurorehabilitation









File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 28 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

225XP0200X Respiratory, Rehabilitative & Restorative Service 4

Providers/Occupational Therapist/Pediatrics



225XR0403X Respiratory, Rehabilitative & Restorative Service 4

Providers/Occupational Therapist/ Rehabilitation,

Driver

226300000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Kinesiotherapist

227800000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory Therapist/Certified



2278C0205X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory Therapist/Certified/Critical

Care

2278E0002X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory

Therapist/Certified/Emergency Care

2278E1000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory Therapist/Certified/Patient

Education

2278G0305X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory Therapist/Certified/Geriatric

Care

2278G1100X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory Therapist/Certified/General

Care

2278H0200X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory Therapist/Certified/Home

Care

2278P1004X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory

Therapist/Certified/Pulmonary Diagnostics

2278P1005X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory

Therapist/Certified/Pulmonary Rehabilitation



File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 29 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

2278P1006X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory

Therapist/Certified/Pulmonary Function

Technologist

2278P3800X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory

Therapist/Certified/Palliative/Hospice

2278P3900X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory

Therapist/Certified/Neonatal/Pediatrics

2278P4000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory Therapist/Certified/Patient

Transport

2278S1500X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory

Therapist/Certified/SNF/Subacute Care

227900000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory Therapist/Registered



2279C0205X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory

Therapist/Registered/Critical Care

2279E0002X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory

Therapist/Registered/Emergency Care

2279E1000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory

Therapist/Registered/Patient Education

2279G0305X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory

Therapist/Registered/Geriatric Care

2279G1100X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory

Therapist/Registered/General Care





File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 30 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

2279H0200X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory Therapist/Registered/Home

Care

2279P1004X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory

Therapist/Registered/Pulmonary Diagnostics



2279P1005X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory

Therapist/Registered/Pulmonary Rehabilitation



2279P1006X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory

Therapist/Registered/Pulmonary Function

Technologist

2279P3800X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory

Therapist/Registered/Palliative/Hospice

2279P3900X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory

Therapist/Registered/Neonatal/Pediatrics

2279P4000X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory

Therapist/Registered/Patient Transport

2279S1500X Respiratory, Rehabilitative & Restorative Service 4

Providers/Respiratory

Therapist/Registered/SNF/Subacute Care

231H00000X Speech, Language and Hearing Service DCP 709 Audiologist 4 Privileged

Providers/Audiologist

231HA2400X Speech, Language and Hearing Service 4

Providers/Audiologist/Assistive Technology

Practitioner

231HA2500X Speech, Language and Hearing Service 4

Providers/Audiologist/Assistive Technology

Supplier



File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 31 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

235500000X Speech, Language and Hearing Service 4

Providers/Specialist/Technologist

2355A2700X Speech, Language and Hearing Service 4

Providers/Specialist/Technologist/Audiology

Assistant

2355S0801X Speech, Language and Hearing Service 4

Providers/Specialist/Technologist/Speech-

Language Assistant

235Z00000X Speech, Language and Hearing Service DCP 710 Speech Therapist 4 Privileged

Providers/Speech-Language Pathologist

237600000X Speech, Language and Hearing Service 4

Providers/Audiologist-Hearing Aid Fitter

237700000X Speech, Language and Hearing Service 4

Providers/Hearing Instrument Specialist

246Q00000X Technologists, Technicians & Other Technical 4

Service

Providers/Specialist/Technologist/Pathology

246QB0000X Technologists, Technicians & Other Technical TECH 214 Blood Bank Officer 4 Privileged

Service

Providers/Specialist/Technologist/Pathology/Path

ology/Blood Banking

246QC1000X Technologists, Technicians & Other Technical TECH 213 Chemistry Lab Officer 4 Privileged

Service

Providers/Specialist/Technologist/Pathology/Che

mistry

246QC2700X Technologists, Technicians & Other Technical 4

Service

Providers/Specialist/Technologist/Pathology/Cytot

echnology

246QH0000X Technologists, Technicians & Other Technical 4

Service

Providers/Specialist/Technologist/Pathology/Hem

atology









File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 32 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

246QH0401X Technologists, Technicians & Other Technical 4

Service

Providers/Specialist/Technologist/Pathology/Hem

apheresis Practitioner

246QH0600X Technologists, Technicians & Other Technical TECH 208 Histopathologist 4 Privileged

Service

Providers/Specialist/Technologist/Pathology/Histo

logy

246QI0000X Technologists, Technicians & Other Technical 4

Service

Providers/Specialist/Technologist/Pathology/Imm

unology

246QL0900X Technologists, Technicians & Other Technical 4

Service

Providers/Specialist/Technologist/Pathology/Labo

ratory Management

246QL0901X Technologists, Technicians & Other Technical 4

Service

Providers/Specialist/Technologist/Pathology/Labo

ratory Management, Diplomate

246QM0706X Technologists, Technicians & Other Technical 4

Service

Providers/Specialist/Technologist/Pathology/Medi

cal Technologist

246QM0900X Technologists, Technicians & Other Technical TECH 203 Medical Microbiologist 4 Privileged

Service

Providers/Specialist/Technologist/Pathology/Micro

biology

246QM0900X Technologists, Technicians & Other Technical TECH 212 Microbiology Lab Officer 4 Privileged

Service

Providers/Specialist/Technologist/Pathology/Micro

biology

246R00000X Technologists, Technicians & Other Technical 4

Service Providers/Technician/Pathology





File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 33 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

246RH0600X Technologists, Technicians & Other Technical 4

Service

Providers/Technician/Pathology/Histology

246RM2200X Technologists, Technicians & Other Technical TECH 210 Biomedical Lab Officer 4 Privileged

Service Providers/Technician/Pathology/Medical

Laboratory



246RM2200X Technologists, Technicians & Other Technical TECH 211 Biomedical Lab Science 4 Privileged

Service Providers/Technician/Pathology/Medical Officer

Laboratory



246RM2200X Technologists, Technicians & Other Technical TECH 215 Chemical Lab Officer, 4 Privileged

Service Providers/Technician/Pathology/Medical Other

Laboratory



246RP1900X Technologists, Technicians & Other Technical 4

Service

Providers/Technician/Pathology/Phlebotomy

246W00000X Technologists, Technicians & Other Technical TECH 905 Cardiopulmonary 4 Non-Privileged

Service Providers/Technician/Cardiology Laboratory Technician



246X00000X Technologists, Technicians & Other Technical 4

Service Providers/Specialist/Technologist

Cardiovascular



246XC1301X Technologists, Technicians & Other Technical 4

Service Providers/Specialist/Technologist

Cardiovascular/Sonography



246XC2901X Technologists, Technicians & Other Technical 4

Service Providers/Specialist/Technologist

Cardiovascular/Cardiovascular Invasive Specialist









File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 34 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

246XC2903X Technologists, Technicians & Other Technical 4

Service Providers/Specialist/Technologist

Cardiovascular/Vascular Specialist



246Y00000X Technologists, Technicians & Other Technical 4

Service Providers/Specialist/Technologist/Health

Information



246YC3301X Technologists, Technicians & Other Technical 4

Service Providers/Specialist/Technologist/Health

Information/Coding Specialist/Hospital Based





246YC3302X Technologists, Technicians & Other Technical 4

Service Providers/Specialist/Technologist/Health

Information/Coding Specialist/Physician Office

Based



246YR1600X Technologists, Technicians & Other Technical 4

Service Providers/Specialist/Technologist/Health

Information/Registered Record Administrator





246Z00000X Technologists, Technicians & Other Technical TECH 900 Medical Technician/ 4 Non-Privileged

Service Providers/Specialist/Technologist/Other Corpsman



246ZA2600X Technologists, Technicians & Other Technical 4

Service

Providers/Specialist/Technologist/Other/Art,

Medical

246ZB0301X Technologists, Technicians & Other Technical 4

Service

Providers/Specialist/Technologist/Other/Biomedic

al Engineering





File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 35 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

246ZB0302X Technologists, Technicians & Other Technical 4

Service

Providers/Specialist/Technologist/Other/Biomedic

al Photographer

246ZB0500X Technologists, Technicians & Other Technical 4

Service

Providers/Specialist/Technologist/Other/Biochemi

st

246ZB0600X Technologists, Technicians & Other Technical 4

Service

Providers/Specialist/Technologist/Other/Biostatisti

cian

246ZE0500X Technologists, Technicians & Other Technical 4

Service

Providers/Specialist/Technologist/Other/EEG



246ZE0600X Technologists, Technicians & Other Technical 4

Service

Providers/Specialist/Technologist/Other/Electrone

urodiagnostic

246ZG0701X Technologists, Technicians & Other Technical 4

Service

Providers/Specialist/Technologist/Other/Graphics

Methods

246ZG1000X Technologists, Technicians & Other Technical 2

Service

Providers/Specialist/Technologist/Other/Geneticis

t/Medical (PhD)

246ZI1000X Technologists, Technicians & Other Technical 4

Service

Providers/Specialist/Technologist/Other/Illustratio

n/Medical









File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 36 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

246ZN0300X Technologists, Technicians & Other Technical 4

Service

Providers/Specialist/Technologist/Other/Nephrolo

gy

246ZS0400X Technologists, Technicians & Other Technical TECH 109 Burn Therapist 4 Privileged

Service

Providers/Specialist/Technologist/Other/Surgical



247000000X Technologists, Technicians & Other Technical 4

Service Providers/Technician/Health Information



2470A2800X Technologists, Technicians & Other Technical 4

Service Providers/Technician/Health

Information/Assistant Record Technician



247100000X Technologists, Technicians & Other Technical 4

Service Providers/Radiologic Technologist



2471B0102X Technologists, Technicians & Other Technical 4

Service Providers/Radiologic Technologist/Bone

Densitometry

2471C1101X Technologists, Technicians & Other Technical 4

Service Providers/Radiologic

Technologist/Cardiovascular-Interventional

Technology

2471C1106X Technologists, Technicians & Other Technical 4

Service Providers/Radiologic

Technologist/Cardiac-Interventional Technology



2471C3401X Technologists, Technicians & Other Technical 4

Service Providers/Radiologic

Technologist/Computed Tomography

2471C3402X Technologists, Technicians & Other Technical 4

Service Providers/Radiologic

Technologist/Radiography



File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 37 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

2471M1202X Technologists, Technicians & Other Technical 4

Service Providers/Radiologic

Technologist/Magnetic Resonance Imaging

2471M2300X Technologists, Technicians & Other Technical 4

Service Providers/Radiologic

Technologist/Mammography

2471N0900X Technologists, Technicians & Other Technical 4

Service Providers/Radiologic

Technologist/Nuclear Medicine Technology

2471Q0001X Technologists, Technicians & Other Technical 4

Service Providers/Radiologic Technologist/Quality

Management

2471R0002X Technologists, Technicians & Other Technical 4

Service Providers/Radiologic

Technologist/Radiation Therapy

2471S1302X Technologists, Technicians & Other Technical 4

Service Providers/Radiologic

Technologist/Sonography

2471V0105X Technologists, Technicians & Other Technical 4

Service Providers/Radiologic

Technologist/Vascular Sonography

2471V0106X Technologists, Technicians & Other Technical 4

Service Providers/Radiologic

Technologist/Vascular-Interventional Technology



247200000X Technologists, Technicians & Other Technical 4

Service Providers/Technician/Other



2472B0301X Technologists, Technicians & Other Technical 4

Service Providers/Technician/Other/Biomedical

Engineering



2472D0500X Technologists, Technicians & Other Technical 4

Service Providers/Technician/Other/Darkroom





File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 38 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

2472E0500X Technologists, Technicians & Other Technical 4

Service Providers/Technician/Other/EEG



2472R0900X Technologists, Technicians & Other Technical 4

Service Providers/Technician/Other/Renal

Dialysis

2472V0600X Technologists, Technicians & Other Technical 4

Service Providers/Technician/Other/Veterinary



363A00000X Physician Assistants & Advanced Practice PA 901 Physician Assistant 4 Privileged

Nursing Providers/Physician Assistant

363AM0700X Physician Assistants & Advanced Practice 4

Nursing Providers/Physician Assistant/Medical



363AS0400X Physician Assistants & Advanced Practice 4

Nursing Providers/Physician Assistant/Surgical



363L00000X Physician Assistants & Advanced Practice APRN 610 Nurse, Clinical Nurse – 4 Non-Privileged

Nursing Providers/Nurse Practitioner Entry Level for Nurse

Practitioner

363LA2100X Physician Assistants & Advanced Practice 4

Nursing Providers/Nurse Practitioner/Acute Care



363LA2200X Physician Assistants & Advanced Practice 4

Nursing Providers/Nurse Practitioner/Adult

Health

363LC0200X Physician Assistants & Advanced Practice 4

Nursing Providers/Nurse Practitioner/Critical Care

Medicine

363LC1500X Physician Assistants & Advanced Practice 4

Nursing Providers/Nurse Practitioner/Community

Health

363LF0000X Physician Assistants & Advanced Practice 4

Nursing Providers/Nurse Practitioner/Family





File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 39 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

363LG0600X Physician Assistants & Advanced Practice 4

Nursing Providers/Nurse

Practitioner/Gerontology

363LN0000X Physician Assistants & Advanced Practice 4

Nursing Providers/Nurse Practitioner/Neonatal



363LN0005X Physician Assistants & Advanced Practice 4

Nursing Providers/Nurse

Practitioner/Neonatal/Critical Care

363LP0200X Physician Assistants & Advanced Practice APRN 603 Pediatric Nurse 4 Privileged

Nursing Providers/Nurse Practitioner/Pediatrics Practitioner



363LP0222X Physician Assistants & Advanced Practice 4

Nursing Providers/Nurse

Practitioner/Pediatrics/Critical Care

363LP0808X Physician Assistants & Advanced Practice APRN 611 Psychiatric Nurse 3 Privileged

Nursing Providers/Nurse Practitioner

Practitioner/Psychiatric/Mental Health

363LP1700X Physician Assistants & Advanced Practice 4

Nursing Providers/Nurse Practitioner/Perinatal



363LP2300X Physician Assistants & Advanced Practice APRN 604 Primary Care Nurse 4 Privileged

Nursing Providers/Nurse Practitioner/Primary Practitioner Qualified

Care

363LP2300X Physician Assistants & Advanced Practice APRN 605 Primary Care Nurse 4 Privileged

Nursing Providers/Nurse Practitioner/Primary Practitioner - Entry

Care

363LS0200X Physician Assistants & Advanced Practice 4

Nursing Providers/Nurse Practitioner/School

363LW0102X Physician Assistants & Advanced Practice 4

Nursing Providers/Nurse Practitioner/Women's

Health

363LX0001X Physician Assistants & Advanced Practice APRN 602 OB/GYN Nurse 4 Privileged

Nursing Providers/Nurse Practitioner/Obstetrics & Practitioner

Gynecology



File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 40 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

363LX0106X Physician Assistants & Advanced Practice 4

Nursing Providers/Nurse

Practitioner/Occupational Health

364S00000X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse Specialist

364SA2100X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse Specialist/Acute

Care

364SA2200X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse Specialist/Adult

Health

364SC0200X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/Critical Care Medicine

364SC1501X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/Community Health/Public Health

364SC2300X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/Chronic Care

364SE0003X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/Emergency

364SE1400X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/Ethics

364SF0001X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse Specialist/Family

Health

364SG0600X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/Gerontology

364SH0200X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse Specialist/Home

Health



File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 41 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

364SH1100X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/Holistic

364SI0800X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/Informatics

364SL0600X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse Specialist/Long-

Term Care

364SM0705X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/Medical-Surgical

364SN0000X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/Neonatal

364SN0800X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/Neuroscience

364SP0200X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/Pediatrics

364SP0807X Physician Assistants & Advanced Practice 3

Nursing Providers/Clinical Nurse

Specialist/Psychiatric/Mental Health/Child &

Adolescent

364SP0808X Physician Assistants & Advanced Practice 3

Nursing Providers/Clinical Nurse

Specialist/Psychiatric/Mental Health

364SP0809X Physician Assistants & Advanced Practice 3

Nursing Providers/Clinical Nurse

Specialist/Psychiatric/Mental Health/Adult

364SP0810X Physician Assistants & Advanced Practice 3

Nursing Providers/Clinical Nurse

Specialist/Psychiatric/Mental Health/Child &

Family



File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 42 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

364SP0811X Physician Assistants & Advanced Practice 3

Nursing Providers/Clinical Nurse

Specialist/Psychiatric/Mental Health/Chronically

Ill

364SP0812X Physician Assistants & Advanced Practice 3

Nursing Providers/Clinical Nurse

Specialist/Psychiatric/Mental Health/Community



364SP0813X Physician Assistants & Advanced Practice 3

Nursing Providers/Clinical Nurse

Specialist/Psychiatric/Mental

Health/Geropsychiatric

364SP1700X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/Perinatal

364SP2800X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/Perioperative

364SR0400X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/Rehabilitation

364SS0200X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/School

364ST0500X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/Transplantation

364SW0102X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/Women's Health

364SX0106X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/Occupational Health









File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 43 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

364SX0200X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/Oncology

364SX0204X Physician Assistants & Advanced Practice 4

Nursing Providers/Clinical Nurse

Specialist/Oncology/Pediatrics

367500000X Physician Assistants & Advanced Practice APRN 094 Anesthetist 4 Privileged

Nursing Providers/Nurse Anesthetist/Certified

Registered

367500000X Physician Assistants & Advanced Practice APRN 612 Nurse Anesthetist 4 Non Privileged -

Nursing Providers/Nurse Anesthetist/Certified with limitations

Registered

367A00000X Physician Assistants & Advanced Practice APRN 608 Certified Nurse Midwife 4 Privileged

Nursing Providers/Midwife/Certified Nurse

367A00000X Physician Assistants & Advanced Practice APRN 609 Nurse Midwife - Entry 4 Privileged

Nursing Providers/Midwife/Certified Nurse Level

367H00000X Physician Assistants & Advanced Practice 4

Nursing Providers/Anesthesiologist Assistant



372500000X Nursing Service Related Providers/Chore 4

Provider

372600000X Nursing Service Related Providers/Adult 4

Companion

373H00000X Nursing Service Related Providers/Day 4

Training/Habilitation Specialist

374700000X Nursing Service Related Providers/Technician 4



3747A0650X Nursing Service Related 4

Providers/Technician/Attendant Care Provider



3747P1801X Nursing Service Related 4

Providers/Technician/Personal Care Attendent



374T00000X Nursing Service Related Providers/Christian 4

Science Practitioner/Nurse



File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 44 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS Provider CMAC UBU Privileges

Version 3.1 Descriptions Version 3.1 Classific Specialty Specialty Provider Assigned

ation Code Descriptions Class



101Y00000X Behavioral Health & Social Service 3

Providers/Counselor

374U00000X Nursing Service Related Providers/Home Health 4

Aide

376G00000X Nursing Service Related Providers/Nursing Home 4

Administrator

376J00000X Nursing Service Related Providers/Homemaker 4



376K00000X Nursing Service Related Providers/Nurse's Aide 4









File: c19095d4-5520-41c4-bf63-26e029403cb7.xls

Tab: CHCSMap Page 45 of 53 Print Date: 11/16/2011

HIPAA Taxonomy to CMAC Provider Class Mapping

HIPAA Code HIPAA Provider Taxonomy Codes and Provider CHCS CHCS CMAC

Version 3.1 Descriptions Version 3.1 Classifica Specialty Provider Provider

tion Code Specialty Class

Descripti

251B00000X Agency, Case Management ons

251C00000X Agency, Day Training, Developmentally

Disabled Services

251E00000X Agency, Home Health

251F00000X Agency, Home Infusion

251G00000X Agency, Hospice Care, Community Based



251300000X Agency, Local Education Agency (LEA)

251J00000X Agency, Nursing Care

251K00000X Agency, Public Health Or Welfare

251V00000X Agency, Voluntary Or Charitable

261QM0855X Ambulatory Hc Facilities, Clinic Center,

Adolescent And Children Mental Health

261QA0600X Ambulatory Hc Facilities, Clinic Center, Adult

Day Care

261QM0850X Ambulatory Hc Facilities, Clinic Center, Adult

Mental Health

261QA0005X Ambulatory Hc Facilities, Clinic Center,

Ambulatory Family Planning Facility

261QA0006X Ambulatory Hc Facilities, Clinic Center,

Ambulatory Fertility Facility

261QA1903X Ambulatory Hc Facilities, Clinic Center,

Ambulatory Surgical

261QA0900X Ambulatory Hc Facilities, Clinic Center,

Amputee

261QA3000X Ambulatory Hc Facilities, Clinic Center,

Augmentative Communication

261QB0400X Ambulatory Hc Facilities, Clinic Center,

Birthing

261QC1500X Ambulatory Hc Facilities, Clinic Center,

Community Health

261QC1800X Ambulatory Hc Facilities, Clinic Center,

Corporate Health

261QC0050X Ambulatory Hc Facilities, Clinic Center,

Critical Access Hospital

261QD0000X Ambulatory Hc Facilities, Clinic Center,

Dental

261QD1600X Ambulatory Hc Facilities, Clinic Center,

Developmental Disabilities

261QE0002X Ambulatory Hc Facilities, Clinic Center,

Emergency Care

261QE0700X Ambulatory Hc Facilities, Clinic Center, End-

Stage Renal (ESRD) Treatment

261QE0800X Ambulatory Hc Facilities, Clinic Center,

Endoscopy

261QF0050X Ambulatory Hc Facilities, Clinic Center,

Family Planning, Non-Surgical

261QF0400X Ambulatory Hc Facilities, Clinic Center,

Federally Qualified Health Center (FQHC)

261QG0250X Ambulatory Hc Facilities, Clinic Center,

Genetics

261QH0100X Ambulatory Hc Facilities, Clinic Center,

Health

261QH0700X Ambulatory Hc Facilities, Clinic Center,

Hearing And Speech

261QI0500X Ambulatory Hc Facilities, Clinic Center,

Infusion Therapy

261QL0400X Ambulatory Hc Facilities, Clinic Center,

Lithotripsy

261QM1200X Ambulatory Hc Facilities, Clinic Center,

Magnetic Resonance Imaging (MRI)

261QM2500X Ambulatory Hc Facilities, Clinic Center,

Medical Specialty

261QM3000X Ambulatory Hc Facilities, Clinic Center,

Medically Fragile Infants And Children Day

Care

261QM0801X Ambulatory Hc Facilities, Clinic Center,

Mental Health (Including Community Mental

Health Center)

261QM2800X Ambulatory Hc Facilities, Clinic Center,

Methadone

261QM1000X Ambulatory Hc Facilities, Clinic Center,

Migrant Health

261QM1101X Ambulatory Hc Facilities, Clinic Center,

Military Ambulatory Procedure

261QM1103X Ambulatory Hc Facilities, Clinic Center,

Military Ambulatory Procedure Visits

Operational (Transportable)

261QM1100X Ambulatory Hc Facilities, Clinic Center,

Military Outpatient

261QM1102X Ambulatory Hc Facilities, Clinic Center,

Military Outpatient Operation (Transportable)

Component

261QM1300X Ambulatory Hc Facilities, Clinic Center, Multi-

Specialty

261QX0100X Ambulatory Hc Facilities, Clinic Center,

Occupational Medicine

261QX0200X Ambulatory Hc Facilities, Clinic Center,

Oncology

261QX0203X Ambulatory Hc Facilities, Clinic Center,

Oncology, Radiation

261QS0132X Ambulatory Hc Facilities, Clinic Center,

Ophthalmologic Surgery

261QS0112X Ambulatory Hc Facilities, Clinic Center, Oral

And Maxillofacial Surgery

261QP3300X Ambulatory Hc Facilities, Clinic Center, Pain

261QP2000X Ambulatory Hc Facilities, Clinic Center,

Physical Therapy

261QP1100X Ambulatory Hc Facilities, Clinic Center,

Podiatric

261QP2300X Ambulatory Hc Facilities, Clinic Center,

Primary Care

261QP2400X Ambulatory Hc Facilities, Clinic Center,

Prison Health

261QP0904X Ambulatory Hc Facilities, Clinic Center,

Public Health, Federal

261QP0905X Ambulatory Hc Facilities, Clinic Center,

Public Health, State Or Local

261QR0200X Ambulatory Hc Facilities, Clinic Center,

Radiology

261QR0206X Ambulatory Hc Facilities, Clinic Center,

Radiology, Mammography

261QR0208X Ambulatory Hc Facilities, Clinic Center,

Radiology, Mobile

261QR0207X Ambulatory Hc Facilities, Clinic Center,

Radiology, Mobile Mammography

261QR0800X Ambulatory Hc Facilities, Clinic Center,

Recovery Care

261QR0400X Ambulatory Hc Facilities, Clinic Center,

Rehabilitation

261QR0401X Ambulatory Hc Facilities, Clinic Center,

Rehabilitation, Comprehensive Outpatient

Rehabilitation Facility

261QR0405X Ambulatory Hc Facilities, Clinic Center,

Rehabilitation, Substance Use Disorder

261QR0404X Ambulatory Hc Facilities, Clinic Center,

Rehabilitation: Cardiac Facilities

261QR1100X Ambulatory Hc Facilities, Clinic Center,

Research

261QR1300X Ambulatory Hc Facilities, Clinic Center, Rural

Health

261QS1200X Ambulatory Hc Facilities, Clinic Center,

Sleep Disorder Diagnostic

261QS1000X Ambulatory Hc Facilities, Clinic Center,

Student Health

261QU0200X Ambulatory Hc Facilities, Clinic Center,

Urgent Care

261QV0200X Ambulatory Hc Facilities, Clinic Center, VA



275N00000X Hospital Units, Medicare Defined Swing Bed

Unit

273R00000X Hospital Units, Psychiatric Unit

273Y00000X Hospital Units, Rehabilitation Unit

276400000X Hospital Units, Rehabilitation, Substance

Use Disorder Unit

287300000X Hospitals, Christian Science Sanitarium

(Hospital Services)

281P00000X Hospitals, Chronic Disease Hospital

281PC2000X Hospitals, Chronic Disease Hospital,

Children

282N00000X Hospitals, General Acute Care Hospital

282NC2000X Hospitals, General Acute Care Hospital,

Children

282NC0060X Hospitals, General Acute Care Hospital,

Critical Access

282NR1301X Hospitals, General Acute Care Hospital,

Rural

282NW0100X Hospitals, General Acute Care Hospital,

Women

286500000X Hospitals, Military Hospital

2865C1500X Hospitals, Military Hospital, Community

Health

2865M2000X Hospitals, Military Hospital, Military General

Acute Care Hospital

2865X1600X Hospitals, Military Hospital, Military General

Acute Care Hospital, Operational

(Transportable)

283Q00000X Hospitals, Psychiatric Hospital

283X00000X Hospitals, Rehabilitation Hospital

284300000X Hospitals, Special Hospital

291U00000X Laboratories, Clinical Medical Laboratory

292200000X Laboratories, Dental Laboratory

291900000X Laboratories, Military Clinical Medical

Laboratory

293D00000X Laboratories, Physiological Laboratory,

(Independent Physiological Lab)

302F00000X Managed Care Organizations, Exclusive

Provider Organization

302R00000X Managed Care Organizations, Health

Maintenance Organization

305S00000X Managed Care Organizations, Point Of

Service

305R00000X Managed Care Organizations, Preferred

Provider Organization

311500000X Nursing And Custodial Care Facilities,

Alzheimer Center/Dementia

Center/Dementia Special Care Unit

310400000X Nursing And Custodial Care Facilities,

Assisted Living Facility

3104A0630X Nursing And Custodial Care Facilities,

Assisted Living Facility, Behavioral

Disturbances

3104A0625X Nursing And Custodial Care Facilities,

Assisted Living Facility, Mental Illness

317400000X Nursing And Custodial Care Facilities,

Christian Science Facility (Skilled Nursing

Services)

311Z00000X Nursing And Custodial Care Facilities,

Custodial Care Facility

311ZA0620X Nursing And Custodial Care Facilities,

Custodial Care Facility, Adult Care Home

315D00000X Nursing And Custodial Care Facilities,

Hospice, Inpatient

315P00000X Nursing And Custodial Care Facilities,

Intermediate Care Facility, Mentally

Retarded

310500000X Nursing And Custodial Care Facilities,

Intermediate Care Facility, Mentally Illness



313M00000X Nursing And Custodial Care Facilities,

Nursing Facility/Intermediate Care Facility

314000000X Nursing And Custodial Care Facilities,

Skilled Nursing Facility

320800000X Residential Treatment Facilities, Community

Based Residential Treatment Facility, Mental

Illness

320900000X Residential Treatment Facilities, Community

Based Residential Treatment Facility, Mental

Retardation And/Or Developmental

Disabilities

323P00000X Residential Treatment Facilities, Psychiatric

Residential Treatment Facility

322D00000X Residential Treatment Facilities, Residential

Treatment Facility, Emotionally Disturbed

Children

320600000X Residential Treatment Facilities, Residential

Treatment Facility, Mental Retardation

And/Or Developmental Disabilities



320700000X Residential Treatment Facilities, Residential

Treatment Facility, Physical Disabilities



324500000X Residential Treatment Facilities, Substance

Abuse Disorder Rehabilitation Facility



3245S0500X Residential Treatment Facilities, Substance

Abuse Disorder Rehabilitation Facility,

Substance Abuse Treatment, Children



385H00000X Respite Care Facility, Respite Care

385HR2050X Respite Care Facility, Respite Care, Respite

Care Camp

385HR2055X Respite Care Facility, Respite Care, Mental

Illness, Child

385HR2060X Respite Care Facility, Respite Care, Mental

Retardation And/Or Developmental

Disabilities, Child

385HR2065X Respite Care Facility, Respite Care, Physical

Disabilities, Child

331L00000X Suppliers, Blood Bank

332100000X Suppliers, Department Of Veteran Affairs

(Va) Pharmacy

332B00000X Suppliers, Durable Medical Equipment &

Medical Supplies

332BC3200X Suppliers, Durable Medical Equipment &

Medical Supplies, Customized Equipment

332BD1200X Suppliers, Durable Medical Equipment &

Medical Supplies, Dialysis Equipment &

Supplies

332BN1400X Suppliers, Durable Medical Equipment &

Medical Supplies, Nursing Facility Supplies



332BX2000X Suppliers, Durable Medical Equipment &

Medical Supplies, Oxygen Equipment &

Supplies

332BP3500X Suppliers, Durable Medical Equipment &

Medical Supplies, Parenteral & Enteral

Nutrition

332G00000X Suppliers, Eye Bank

332H00000X Suppliers, Eyewear Supplier

332S00000X Suppliers, Hearing Aid Equipment

332U00000X Suppliers, Homer Delivered Meals

332800000X Suppliers, Indian Health

Service/Tribal/Urban Indian Health (I/T/U)

Pharmacy

332000000X Suppliers, Military Pharmacy

332900000X Suppliers, Non-Pharmacy Dispensing Site

335U00000X Suppliers, Organ Procurement Organization



333600000X Suppliers, Pharmacy

3336C0002X Suppliers, Pharmacy, Clinic Pharmacy

3336C0003X Suppliers, Pharmacy, Community/Retail

Pharmacy

3336H0001X Suppliers, Pharmacy, Home Infusion

Therapy Pharmacy

3336I0012X Suppliers, Pharmacy, Institutional Pharmacy



3336L0003X Suppliers, Pharmacy, Long Term Care

Pharmacy

3336M0002X Suppliers, Pharmacy, Mail Order Pharmacy



3336M0003X Suppliers, Pharmacy, Managed Care

Organization Pharmacy

3336N0007X Suppliers, Pharmacy, Nuclear Pharmacy

3336S0011X Suppliers, Pharmacy, Specialty Pharmacy



335V00000X Suppliers, Portable XRay Supplier

335E00000X Suppliers, Prosthetic/Orthotic Supplier

341600000X Transportation Services, Ambulance

3416A0800X Transportation Services, Ambulance, Air

Transport

3416L0300X Transportation Services, Ambulance, Land

Transport

3416S0300X Transportation Services, Ambulance, Water

Transport

347B00000X Transportation Services, Bus

341800000X Transportation Services, Military Transport

3418M1120X Transportation Services, Military Transport,

Military Ambulance, Air Transport



3418M1110X Transportation Services, Military Transport,

Military Ambulance, Ground Transport



3418M1130X Transportation Services, Military Transport,

Military Ambulance, Water Transport



343900000X Transportation Services, Non-Emergency

Medical Transport (Van)

347C00000X Transportation Services, Private Vehicle

343800000X Transportation Services, Secured Medical

Transport (Van)

344600000X Transportation Services, Taxi

347D00000X Transportation Services, Train

347E00000X Transportation Services, Transportation

Broker

UBU

Privileges

Assigned