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Provider Specialty Codes

All physicians, practitioners, and other suppliers who provide services to Medicare beneficiaries must enroll in the Medicare program before claims can be submitted. At the time of enrollment, Medicare assigns a two-digit specialty code that corresponds to the specialty type declared by the applicant on the enrollment form. The specialties listed below are the only specialties currently recognized by the Centers for Medicare & Medicaid Services (CMS) for purposes of enrollment in the Medicare program by Part B Medicare carriers.

Physician Specialty Codes

01 General Practice   34 Urology
02 General Surgery   35 Chiropractic
03 Allergy/Immunology   36 Nuclear Medicine
04 Otolaryngology   37 Pediatric Medicine
05 Anesthesiology   38 Geriatric Medicine
06 Cardiology   39 Nephrology
07 Dermatology   40 Hand Surgery
08 Family Practice   41 Optometry
09 Interventional Pain Management   44 Infectious Disease
10 Gastroenterology   46 Endocrinology
11 Internal Medicine   48 Podiatry
12 Osteopathic Manipulative Medicine   66 Rheumatology
13 Neurology   70 Clinic/Group Practice
14 Neurosurgery   72 Pain Management
16 Obstetrics/Gynecology   76 Peripheral Vascular Disease
17 Hospice and Pallative Care   77 Vascular Surgery
18 Ophthalmology   78 Cardiac Surgery
19 Oral Surgery (dentists only)   79 Addiction Medicine
20 Orthopedic Surgery   81 Critical Care (Intensivists)
21 Cardiac Electrophysiology   82 Hematology
22 Pathology   83 Hematology/Oncology
23 Sports Medicine   84 Preventive Medicine
24 Plastic and Reconstructive Surgery   85 Maxillofacial Surgery
25 Physical Medicine and Rehabilitation   90 Medical Oncology
26 Psychiatry   91 Surgical Oncology
27 Geriatric Psychiatry   92 Radiation Oncology
28 Colorectal Surgery   93 Emergency Medicine
29 Pulmonary Disease   94 Interventional Radiology
30 Diagnostic Radiology   98 Gynecological/Oncology
33 Thoracic Surgery   C0 Sleep Medicine

Supplier and Non-Physician Practitioner Codes

15 Speech Language Pathologist in Private Practice   64 Audiologist
31 Intensive Cardiac Rehabilitation  65 Physical Therapist in Private Practice
32 Anesthesiologist Assistant  67 Occupational Therapist in Private Practice
42 Certified Nurse Midwife  68 Clinical Psychologist
43 Certified Registered Nurse Anesthetist (CRNA)  69 Independent Clinical Laboratory
45 Mammography Screening Center  71 Registered Dietitian/Nutrition Professional
47 Independent Diagnostic Testing Facility (IDTF)  73 Mass Immunization Roster Biller
49 Ambulatory Surgical Center  74 Radiation Therapy Centers
50 Nurse Practitioner  80 Clinical Social Worker
59 Ambulance Service Supplier  87 Pharmacy
62 Psychologist (billing independently)  89 Clinical Nurse Specialist
63 Portable X-ray Supplier (billing independently)  97 Physician Assistant

Primary/Secondary Specialty Codes

Physicians may designate only one primary specialty but may designate multiple secondary specialties on the CMS 855I enrollment form. Non-physician practitioners who want to enroll as more than one non-physician specialty type must submit a separate CMS-855I enrollment form for each specialty.

Changes in Specialty Codes

Physicians should monitor their specialty status to ensure that they are enrolled in the specialty type that most accurately represents their practice. This is particularly important as physicians change the focus of their practice and become more specialized. Failure to notify Medicare of specialty changes can affect reimbursement. Use form CMS 855I to report specialty changes.

Page Last Updated: Wednesday, 26-Nov-2014 12:29:49 CST