Attachment 4 — BadgerCare Plus Required Taxonomy Codes - April 2008 BadgerCare Plus Update 2008-30

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Attachment 4 — BadgerCare Plus Required Taxonomy Codes

Provider Type	Provider Specialty	Taxonomy Code	Taxonomy Description
Ambulance	Air Ambulance	3416A0800X	Air Transport
Ambulance	Land Ambulance	3416L0300X	Land Transport
Ambulance	Water Ambulance	3416S0300X	Water Transport
Ambulatory Surgical Center	N/A	261QA1903X	Ambulatory Surgical
Anesthetist	Anesthesiologist Assistant	367H00000X	Anesthesiologist Assistant
Anesthetist	Certified Registered Nurse Anesthetist Certified Registered Nurse Anesthetist Group	367500000X	Nurse Anesthetist, Certified Registered
Audiologist	Audiologist Audiology Group	231H00000X	Audiologist
Case Management	All	251B00000X	Case Management
Chiropractor	Chiropractor Chiropractic Group	111N00000X	Chiropractor
Community Support Program	All	251S00000X	Community/Behavioral Health
Comprehensive Community Services	All	251S00000X	Community/Behavioral Health
Crisis Intervention	All	251S00000X	Community/Behavioral Health
Day Treatment	Adult Mental Health Substance Abuse	261Q00000X	Clinic/Center
Day Treatment	Child Adolescent	261QM0855X	Adolescent and Children Mental Health
Dentist	Endodontics	1223E0200X	Endodontics
Dentist	General Practice	1223G0001X	General Practice
Dentist	Oral Pathology	1223P0106X	Oral and Maxillofacial Pathology
Dentist	Oral Surgery	1223S0112X	Oral and Maxillofacial Surgery
Dentist	Orthodontics	1223X0400X	Orthodontics and Dentofacial Orthopedics
Dentist	Pediatric Dentist	1223P0221X	Pediatric Dentistry
Dentist	Periodontics	1223P0300X	Periodontics
Dentist	Prosthodontics	1223P0700X	Prosthodontics
Dental Group	N/A	261QD0000X	Dental
Dental Hygienist	N/A	124Q00000X	Dental Hygienist
End Stage Renal Disease (ESRD)	All	261QE0700X	ESRD Treatment
Facility for the Developmentally Disabled	All	315P00000X	Intermediate Care Facility
Family Planning Clinic	All	261QF0050X	Family Planning, Non-Surgical
Federally Qualified Health Clinic (FQHC)	N/A	261QF0400X	FQHC
HealthCheck	All	261QP2300X	Clinic Center/Primary
HealthCheck “Other Services”	N/A	261QH0100X	Health Service
Hearing Instrument Specialist	Hearing Instrument Specialist Hearing Instrument Specialist Group	237700000X	Hearing Instrument Specialist
Home Health/Personal Care Agency	Home Health Only Provider Home Health/Personal care Dually Certified Provider	251E00000X	Home Health
Hospice	All	251G00000X	Hospice Care, Community Based
Hospital	Inpatient/Outpatient Hospital	282N00000X	General Acute Care Hospital
Independent Lab	Independent Lab	291U00000X	Clinical Medical Laboratory
Individual Medical Supply	Federally Qualified Health Center (FQHC)	332B00000X	Durable Medical Equipment & Medical Supplies
Individual Medical Supply	Orthotist Orthotist/Prosthetist	222Z00000X	Orthotist
Individual Medical Supply	Prosthetist	224P00000X	Prosthetic
Individual Medical Supply	Specialties other than Federally Qualified Health Center (FQHC), Orthotist, Prosthetist, and Orthotist/Prosthetist	335E00000X	Prosthetic Orthotic Supplier
Institution for Mental Disease	All	283Q00000X	Psychiatric Hospital
Medical Vendor	Federally Qualified Health Center (FQHC)	261QF0400X	FQHC
Medical Vendor	Medical Equipment/Supplies	332B00000X	Durable Medical Equipment & Medical Supplies
Mental Health and Substance Abuse Agency	All	261QM0801X	Mental Health, including Community Mental Health
Mental Health and Substance Abuse Services Provided by Individuals	Advanced Practice Nurse Prescriber	363LP0808X	Psychiatric/Mental Health
Mental Health and Substance Abuse Services Provided by Individuals	Alcohol and Other Drug Abuse (AODA) Counselor	101YA0400X	Addiction (Substance Use Disorder)
Mental Health and Substance Abuse Services Provided by Individuals	Licensed Psychologist (PhD) Licensed Psychologist (PhD) Group	103T00000X	Psychologist
Mental Health and Substance Abuse Services Provided by Individuals	Master’s-Level Psychotherapist Master’s-Level Psychotherapist/Alcohol and Other Substance Abuse (AODA) Counselor	104100000X	Social Worker
Mental Health and Substance Abuse Services Provided by Individuals	Psychiatric Nurse	163WP0808X	Psychiatric/Mental Health Registered Nurse
Narcotic Treatment Service	Licensed Practical Nurse (LPN)	164W000000X	LPN
Narcotic Treatment Service	Registered Alcohol and Drug Counselor (AODA)/Narcotic Treatment Service	101YA0400X	Addiction (Substance Use Disorder)
Narcotic Treatment Service	Registered Nurse (RN)	163WA0400X	Addiction (Substance Use Disorder)
Narcotic Treatment Service Agency	N/A	261QM2800X	Methadone
Nurse Practitioner	Certified Family Nurse Practitioner	363LF0000X	Family
Nurse Practitioner	Certified Pediatric Nurse Practitioner	363LP0200X	Pediatrics
Nurse Practitioner	Nurse Practitioner/Nurse Midwife	367A00000X	Midwife, Certified Nurse
Nurse Practitioner	Specialties other than Pediatric Nurse Practitioner, Family Nurse Practitioner, Nurse Practitioner/Nurse Midwife Group	363L00000X	Nurse Practitioner
Nurses in Independent Practice	Licensed Practical Nurse (LPN)	164W00000X	LPN
Nurses in Independent Practice	Registered Nurse (RN)	163W00000X	RN
Nurse Midwife	N/A	176B00000X	Midwife, Certified
Nursing Facility	N/A	314000000X	Skilled Nursing Facility
Occupational Therapy	Occupational Therapist Occupational Therapy Group	225X00000X	Occupational Therapist
Occupational Therapy	Occupational Therapy Assistant	224Z00000X	Occupational Therapy Assistant
Optician	Optician	156FX1800X	Optician
Optometry	Optometrist Optometry Group	152W00000X	Optometrist
Pharmacy	Pharmacy	333600000X	Pharmacy
Physical Therapy	Group	261QP2000X	Physical Therapy
Physical Therapy	Physical Therapist	225100000X	Physical Therapist
Physical Therapy	Physical Therapy Assistant	225200000X	Physical Therapy Assistant
Physician Clinic	Multi-Specialty	193200000X	Multi-Specialty
Physician and Physician Specialty Clinic	Allergy and Immunology	207K00000X	Allergy and Immunology
Physician and Physician Specialty Clinic	Anesthesiology	207L00000X	Anesthesiology
Physician and Physician Specialty Clinic	Cardiovascular Disease	207RC0000X	Cardiovascular Disease
Physician and Physician Specialty Clinic	Dermatology	207N00000X	Dermatology
Physician and Physician Specialty Clinic	Emergency Medicine	207P00000X	Emergency Medicine
Physician and Physician Specialty Clinic	Family Practice	207Q00000X	Family Practice
Physician and Physician Specialty Clinic	Gastroenterology	207RG0100X	Gastroenterology
Physician and Physician Specialty Clinic	General Practice	208D00000X	General Practice
Physician and Physician Specialty Clinic	General Surgery	208600000X	Surgery
Physician and Physician Specialty Clinic	Geriatrics	207QG0300X	Geriatric Medicine
Physician and Physician Specialty Clinic	Internal Medicine	207R00000X	Internal Medicine
Physician and Physician Specialty Clinic	Manipulative Therapy	208D00000X	General Practice
Physician and Physician Specialty Clinic	Miscellaneous	208D00000X	General Practice
Physician and Physician Specialty Clinic	Nephrology	207RN0300X	Nephrology
Physician and Physician Specialty Clinic	Neurological Surgery	207T00000X	Neurological Surgery
Physician and Physician Specialty Clinic	Neurology	2084N0400X	Neurology
Physician and Physician Specialty Clinic	Nuclear Medicine	207U00000X	Nuclear Medicine
Physician and Physician Specialty Clinic	Obstetrics and Gynecology	207V00000X	Obstetrics and Gynecology
Physician and Physician Specialty Clinic	Oncology and Hematology	207RH0003X	Hematology and Oncology
Physician and Physician Specialty Clinic	Ophthalmology	207W00000X	Ophthalmology
Physician and Physician Specialty Clinic	Orthopedic Surgery	207X00000X	Orthopedic Surgery
Physician and Physician Specialty Clinic	Otolaryngology	207Y00000X	Otolaryngology
Physician and Physician Specialty Clinic	Pathology	207ZC0500X	Pathologist
Physician and Physician Specialty Clinic	Pediatrician Pediatric Allergy Pediatric Cardiology	208000000X	Pediatrics
Physician and Physician Specialty Clinic	Physical Medicine and Rehab	208100000X	Physical Medicine and Rehabilitation
Physician and Physician Specialty Clinic	Plastic Surgery	208200000X	Plastic Surgery
Physician and Physician Specialty Clinic	Preventative Medicine	2083P0901X	Public Health and General Preventative Medicine
Physician and Physician Specialty Clinic	Proctology	208C00000X	Colon and Rectal Surgery
Physician and Physician Specialty Clinic	Psychiatry	2084P0800X	Psychiatry
Physician and Physician Specialty Clinic	Pulmonary Disease	207RP1001X	Pulmonary Disease
Physician and Physician Specialty Clinic	Radiation Therapy	2085R0202X	Diagnostic Radiology
Physician and Physician Specialty Clinic	Radiology	2085R0202X	Diagnostic Radiology
Physician and Physician Specialty Clinic	Thoracic and Cardiovascular Surgery	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery)
Physician and Physician Specialty Clinic	Urgent Care	208D00000X	General Practice
Physician and Physician Specialty Clinic	Urology	208800000X	Urology
Physician Assistant	N/A	363A00000X	Physician Assistant
Podiatry	Podiatrist Podiatry Group	213E00000X	Podiatrist
Portable X-Ray	N/A	261QR0208X	Radiology Mobile
Prenatal Care Coordination	All	251B00000X	Case Management
Rehabilitation Agency	All	261QR0400X	Rehabilitation
Rural Health Clinic	All	261QR1300X	Rural Health
School-Based Services	All	251300000X	Local Education Agency
Speech and Hearing Clinic	N/A	261QH0700X	Hearing and Speech
Speech-Language Pathology	Speech Language Pathology- Bachelor’s Level	2355S0801X	Speech-Language Assistant
Speech-Language Pathology	Speech Language Pathology- Master’s Level	235Z00000X	Speech-Language Pathologist
Speech-Language Pathology Clinic	N/A	235Z00000X	Speech-Language Pathologist
Therapy Group	Group	261QR0400X	Rehabilitation