To help ensure accurate reimbursement, it is important that the provider types outlined below report the following taxonomy codes to Anthem when providing services in the referenced medical capacity.

 

Please reference the NUCC guidelines for further CMS-1500 claim reporting guidance.

 

Advanced practice registered nurses/mid-wives

 

APRN

CRNA

MID-WIFE

Surgical first assist

163WR0006X

 

163WR0006X

Behavioral health

363LP0808X

 

 

Anesthesia

 

367500000X

 

 

Physician assistants

Surgical first assist

363AS0400X

Behavioral health

363A00000X

Primary care (pcp)

363AM0700X

Specialist

363AM0700X

 

Behavioral health facilities

If you are a behavioral health facility that bills Anthem at the organizational level on the CMS 1500, report the following taxonomy codes in the Billing Taxonomy field on the CMS-1500 (paper - field 33b, electronic - Loop 2000A/Segment PRV - field 39)

Adult psychiatrist (MD/DO)

2084P0800X

Child psychiatrist (MD/DO)

2084P0804X

Psychologist (PhD)

103TC0700X

Advanced practice nurse (APRN)

363LP0808X

Masters (MDIV, LPC, LCSW, LCPC, RNCS, etc.)

193200000X

 

1466-1221-PN-ME



Featured In:
December 2021 Anthem Maine Provider News