news article details

Billing Tip for COVID-19 Vaccine as a Mass Immunizer Roster Biller - Use the Taxonomy Code

National Government Services highly recommends that Part B providers who are credentialed as a Mass Immunizer (specialty 73) and have multiple PTANs linked to one NPI, use the assigned taxonomy code on the electronic claim submissions.

CMS developed a crosswalk of taxonomy codes that links the types of providers and suppliers who are eligible to apply for enrollment in the Medicare Program with the appropriate Healthcare Provider Taxonomy Codes.

For COVID-19 vaccine administration billing purposes, CMS is allowing specialty 73 to use the code set assigned to specialty A5 (pharmacy/suppliers) or specialty 58 (medical supply company w/registered pharmacist). This will ensure that the Medicare claims processing system selects the correct Medicare PTAN for your roster bills, the claims are processed without manual intervention and are correctly adjudicated.

When a taxonomy code is improperly used or not reported it can cause the following issues during claim processing:

    • Delay in processing/payment
    • Claim denials
    • Improper payments

The taxonomy code, on the electronic claim submission, should be referenced as the following:

    • Loop: 2000A
    • Segment: PRV
    • Element:
      • 01= BI for billing
      • 02= PXC for Reference Identification Qualifier
      • 03= Taxonomy Code

Example: PRV✽BI✽PXC✽207Q00000X~

Revised 6/14/2021
Posted 3/25/2021