What is taxonomy code

A taxonomy code is a unique character, alphanumeric code that identifies your specialty at the claim level. Express Scripts, our pharmacy benefit manger, will use the taxonomy code associated with the National Provider Identifier NPI number and in the NPPES to validate whether a provider has the authority to prescribe controlled substances.

If the taxonomy code listed with the NPI is incorrect, your patients may not be able to fill prescriptions for controlled substances at the pharmacy. This is being done to meet the requirements of the state prescriptive authority rules for our ConnectiCare Medicare Advantage members. Any information provided on this Website is for informational purposes only.

It is not medical advice and should not be substituted for regular consultation with your health care provider. If you have any concerns about your health, please contact your health care provider's office. Also, this information is not intended to imply that services or treatments described in the information are covered benefits under your plan.

Please refer to your Membership. Agreement, Certificate of Coverage, Benefit Summary, or other plan documents for specific information about your benefits coverage. Switch to: providers brokers employers. The middle five characters vary depending on the Level 3 Area of Specialization. Proceed With Caution Capitalization — This specific code set only uses capital letters.

If you submit claims using lower case letters, the taxonomy code will not be recognized. Multi-Specialty vs. A mistake on the fourth character will misclassify your practice. Updates — Taxonomy codes are updated twice a year.

The first updates are published in January and go into effect on April 1. The second updates are published in July and are implemented in October. A practice management system can improve coding at your practice. Our checklist will help you choose one. Ongoing duties, including processing taxonomy code requests and maintenance of the code set, fall under the NUCC Code Subcommittee.

To request new codes or modifications to existing codes in the code set, complete the following form and email it to: This email address is being protected from spambots. You need JavaScript enabled to view it. Please review the criteria closely and provide all necessary information.