Variable: PRVDR_SPCLTY
Line CMS Provider Specialty Code
Description
CMS (previously called HCFA) specialty code used for pricing the line item service on the non-institutional claim. Assigned by the Medicare Administrative Contractor (MAC) based on the corresponding provider identification number (performing NPI or UPIN).
Comment
n/a
Values
This variable is coded, and will contain one of the following values.
| Value | Description |
|---|---|
| 00 | Carrier wide |
| 01 | General practice |
| 02 | General surgery |
| 03 | Allergy/immunology |
| 04 | Otolaryngology |
| 05 | Anesthesiology |
| 06 | Cardiology |
| 07 | Dermatology |
| 08 | Family practice |
| 09 | Interventional Pain Management (IPM) (eff. 4/1/03) |
| 10 | Gastroenterology |
| 11 | Internal medicine |
| 12 | Osteopathic manipulative therapy |
| 13 | Neurology |
| 14 | Neurosurgery |
| 15 | Speech / language pathology |
| 16 | Obstetrics/gynecology |
| 17 | Hospice and Palliative Care |
| 18 | Ophthalmology |
| 19 | Oral surgery (dentists only) |
| 20 | Orthopedic surgery |
| 21 | Cardiac Electrophysiology |
| 22 | Pathology |
| 24 | Plastic and reconstructive surgery |
| 25 | Physical medicine and rehabilitation |
| 26 | Psychiatry |
| 27 | General Psychiatry |
| 28 | Colorectal surgery (formerly proctology) |
| 29 | Pulmonary disease |
| 30 | Diagnostic radiology |
| 31 | Intensive cardiac rehabilitation |
| 32 | Anesthesiologist Assistants (eff. 4/1/03--previously grouped with Certified Registered Nurse Anesthetists [CRNA]) |
| 33 | Thoracic surgery |
| 34 | Urology |
| 35 | Chiropractic |
| 36 | Nuclear medicine |
| 37 | Pediatric medicine |
| 38 | Geriatric medicine |
| 39 | Nephrology |
| 40 | Hand surgery |
| 41 | Optometrist |
| 42 | Certified nurse midwife |
| 43 | Certified Registered Nurse Anesthetist (CRNA) (Anesthesiologist Assistants were removed from this specialty 4/1/03) |
| 44 | Infectious disease |
| 45 | Mammography screening center |
| 46 | Endocrinology |
| 47 | Independent Diagnostic Testing Facility (IDTF) |
| 48 | Podiatry |
| 49 | Ambulatory surgical center (formerly miscellaneous) |
| 50 | Nurse practitioner |
| 51 | Medical supply company with certified orthotist (certified by American Board for Certification in Prosthetics and Orthotics) |
| 52 | Medical supply company with certified prosthetist (certified by American Board for Certification in Prosthetics and Orthotics) |
| 53 | Medical supply company with certified prosthetist-orthotist (certified by American Board for Certification in Prosthetics and Orthotics) |
| 54 | Medical supply company for DMERC (and not included in 51-53) |
| 55 | Individual certified orthotist |
| 56 | Individual certified prosthetist |
| 57 | Individual certified prosthetist-orthotist |
| 58 | Medical supply company with registered pharmacist |
| 59 | Ambulance service supplier, (e.g., private ambulance companies, funeral homes, etc.) |
| 60 | Public health or welfare agencies (federal, state, and local) |
| 61 | Voluntary health or charitable agencies (e.g. National Cancer Society, National Heart Association, Catholic Charities) |
| 62 | Psychologist (billing independently) |
| 63 | Portable X-ray supplier |
| 64 | Audiologist (billing independently) |
| 65 | Physical therapist (private practice added 4/1/03) (independently practicing removed 4/1/03) |
| 66 | Rheumatology |
| 67 | Occupational therapist (private practice added 4/1/03) (independently practicing removed 4/1/03) |
| 68 | Clinical psychologist |
| 69 | Clinical laboratory (billing independently) |
| 70 | Multispecialty clinic or group practice |
| 71 | Registered Dietician/Nutrition Professional (eff. 1/1/02) |
| 72 | Pain Management (eff. 1/1/02) |
| 73 | Mass Immunization Roster Biller |
| 74 | Radiation Therapy Centers (prior to 4/2003 this included Independent Diagnostic Testing Facilities (IDTF) |
| 75 | Slide Preparation Facilities (added to differentiate them from Independent Diagnostic Testing Facilities (IDTFs -- eff. 4/1/03) |
| 76 | Peripheral vascular disease |
| 77 | Vascular surgery |
| 78 | Cardiac surgery |
| 79 | Addiction medicine |
| 80 | Licensed clinical social worker |
| 81 | Critical care (intensivists) |
| 82 | Hematology |
| 83 | Hematology/oncology |
| 84 | Preventive medicine |
| 85 | Maxillofacial surgery |
| 86 | Neuropsychiatry |
| 87 | All other suppliers (e.g. drug and department stores) |
| 88 | Unknown supplier/provider specialty |
| 89 | Certified clinical nurse specialist |
| 90 | Medical oncology |
| 91 | Surgical oncology |
| 92 | Radiation oncology |
| 93 | Emergency medicine |
| 94 | Interventional radiology |
| 95 | Competitive Acquisition Program (CAP) Vendor (eff. 07/01/06). Prior to 07/01/06, known as Independent physiological laboratory |
| 96 | Optician |
| 97 | Physician assistant |
| 98 | Gynecologist/oncologist |
| 99 | Unknown physician specialty |
| A0 | Hospital (DMERCs only) |
| A1 | SNF (DMERCs only) |
| A2 | Intermediate care nursing facility (DMERCs only) |
| A3 | Nursing facility, other (DMERCs only) |
| A4 | Home Health Agency (DMERCs only) |
| A5 | Pharmacy (DMERC) |
| A6 | Medical supply company with respiratory therapist (DMERCs only) |
| A7 | Department store (DMERC) |
| A8 | Grocery store (DMERC) |
| A9 | Indian Health Service (IHS), tribe and tribal organizations (non-hospital or non-hospital based facilities, eff. 1/2005) |
| B1 | Supplier of oxygen and/or oxygen related equipment (eff. 10/2/07) |
| B2 | Pedorthic Personnel (eff. 10/2/07) |
| B3 | Medical Supply Company with pedorthic personnel (eff. 10/2/07) |
| B4 | Does not meet definition of health care provider (e.g., Rehabilitation agency, organ procurement organizations, histocompatibility labs) (eff. 10/2/07) |
| B5 | Ocularist |
| C0 | Sleep medicine |
| C1 | Centralized flu |
| C2 | Indirect payment procedure |
| C3 | Interventional cardiology |
Other Info
Some additional information on this variable:
- Short Name: HCFASPCL
- Long Name: PRVDR_SPCLTY
- Type: CHAR
- Length: 3
- Source: NCH
- Value Format: