Provider Characteristics Codes

Reference > Code Lists > Health Care >

Health Care Provider Characteristics Codes LAST UPDATED 7/1/2015

This code list is for use with health care provider information for enrollment and credentialing transactions and their corresponding responses. It is intended to provide codified responses to questions presented to a health care provider applying to or registering with an entity and to report the outcome of such application or registration. It may also be used for responses to inquiries regarding provider participation or registration in a program or plan.

Filter Codes by Status: Show All Current | To Be Deactivated | Deactivated

10	Provider has a medical condition that impairs or limits him/her to practice Start: 01/01/2004
11	Provider receives public funding Start: 01/01/2004
12	This is a multi-specialty group Start: 01/01/2004 \| Stop: 10/01/2005
13	This is a primary care group Start: 01/01/2004
14	Provider has ownership or financial interest in another medical establishment Start: 01/01/2004
15	Professional liability coverage has been restricted/terminated/or modified Start: 01/01/2004
16	This is the provider’s primary insurance coverage Start: 01/01/2004
17	This is the provider’s excess insurance coverage Start: 01/01/2004
18	Excess insurance coverage exists for this provider Start: 01/01/2004
19	Provider is self-insured Start: 01/01/2004
1A	Provider’s self-insurance is funded Start: 01/01/2004
1B	Provider’s self-insurance is not funded Start: 01/01/2004
1C	Provider has had adverse action on state license, certificate, or registration Start: 01/01/2004
1D	Provider has had adverse action on DEA or other applicable narcotic registration Start: 01/01/2004
1E	Provider has had adverse action on hospital or other health care facility staff membership for privileges Start: 01/01/2004
1F	Provider has had adverse action on professional organization membership Start: 01/01/2004
1G	Provider has had adverse action on Medicare, Medicaid or other government health programs Start: 01/01/2004
1H	Provider has had adverse action on any prepaid health plan or managed care participation Start: 01/01/2004
1I	Provider has had adverse action with respect to educational or training institution or program Start: 01/01/2004
1J	Provider has had adverse action by professional society or association Start: 01/01/2004
1K	Provider is under health plan administrative sanction Start: 01/01/2004
1L	Provider accepts Workers’ Compensation Start: 01/01/2004
1M	Provider accepts Medicare assignment Start: 01/01/2004
1N	Provider accepts Medicaid assignment Start: 01/01/2004
1O	Provider participates in Medicare and accepts assignment Start: 01/01/2004
1P	Provider participates in Medicaid and accepts assignment Start: 01/01/2004
1Q	Provider is not accepting new patients for obstetric care Start: 01/01/2004
1R	This location is handicapped accessible Start: 01/01/2004
1S	This location is less than 1 block from public transportation Start: 01/01/2004
1T	This location is less than 5 blocks from public transportation Start: 01/01/2004
1U	This location is less than 1 mile from public transportation Start: 01/01/2004
1V	This location is 1 or more miles from public transportation Start: 01/01/2004
1W	This location has a full time assistant available Start: 01/01/2004
1X	This location has a part time assistant available Start: 01/01/2004
1Y	This location has Telecommunication Device for the Deaf (TDD) equipment Start: 01/01/2004
1Z	This location is medically fragile equipped Start: 01/01/2004
20	This location employs para-professional staff/employees Start: 01/01/2004
21	This location maintains para-professional credentialing, licensure & malpractice information Start: 01/01/2004
22	This location admits and cares for patients on its own hospital service Start: 01/01/2004
23	The scheduling time for urgent care at this location is more than 24 hours Start: 01/01/2004
24	The scheduling time for symptomatic care at this location is more than 72 hours Start: 01/01/2004
25	The scheduling time for routine visits at this location is more than 7 days Start: 01/01/2004
26	The scheduling time for preventive routine care at this location is more than 30 days Start: 01/01/2004
27	The waiting time at this location is more than 30 minutes from time of scheduled appointment Start: 01/01/2004
28	Allergy skin testing is provided at this location Start: 01/01/2004
29	Asthma treatment is provided at this location Start: 01/01/2004
2A	EKG services are provided at this location Start: 01/01/2004
2B	Flexible sigmoidoscopy is provided at this location Start: 01/01/2004
2C	IV hydration/treatment is provided at this location Start: 01/01/2004
2D	Laceration repair is provided at this location Start: 01/01/2004
2E	Laboratory services/testing is provided at this location Start: 01/01/2004
2F	Massage therapy is provided at this location Start: 01/01/2004
2G	Minor fracture work is provided at this location Start: 01/01/2004
2H	Minor surgery is provided at this location Start: 01/01/2004
2I	Occupational therapy is provided at this location Start: 01/01/2004
2J	Gynecology services are provided at this location Start: 01/01/2004
2K	Obstetric services are provided at this location Start: 01/01/2004
2L	Osteopathic manipulation is provided at this location Start: 01/01/2004
2M	Physical therapy is provided at this location Start: 01/01/2004
2N	Pulmonary function studies are provided at this location Start: 01/01/2004
2O	Speech pathology is provided at this location Start: 01/01/2004
2P	Hearing tests are provided at this location Start: 01/01/2004
2Q	Visual screenings are provided at this location Start: 01/01/2004
2R	Mammography services are provided at this location Start: 01/01/2004
2S	X-rays are provided at this location Start: 01/01/2004
2T	This hospital has a Medicare Prospective Payment System (PPS) exempt rehabilitation unit Start: 01/01/2004
2U	This hospital has a Medicare Prospective Payment System (PPS) exempt psychiatric unit Start: 01/01/2004
2V	Assistive aid information not collected from the provider Start: 10/01/2006
55	Accepted Start: 01/01/2004
56	Unspecified Error Start: 01/01/2004
57	Failed Field Edits Start: 01/01/2004
58	Minimum Fields Missing Start: 01/01/2004
59	Exact Duplicate Start: 01/01/2004
5A	Rejected by NPI Enumerator Start: 01/01/2004
5B	Invalid Taxonomy Code Start: 01/01/2004
5C	Taxonomy Code Mismatch Start: 01/01/2004
5D	SSN Validation Error Start: 01/01/2004
5E	Mailing Address Error Start: 01/01/2004
5F	Location Address Error Start: 01/01/2004
5G	NPI not on File Start: 01/01/2004
5H	Invalid Deactivation Reason Code Start: 01/01/2004
5I	Pended by GateKeeper Start: 01/01/2004
5J	Pended by L/S/T Start: 01/01/2004
5K	Duplicate record Start: 01/01/2004
5L	Schema validation failed Start: 01/01/2004
5M	Individual Verification – Found Start: 01/01/2004
5N	Individual Verification - Not Found Start: 01/01/2004
5O	Individual Verification - Close Match Start: 01/01/2004
5P	Individual Verification – Insufficient Data Start: 01/01/2004
5Q	Organization Verification – Found Start: 01/01/2004
5R	Organization Verification - Not Found Start: 01/01/2004
5S	Organization Verification – Close Match Start: 01/01/2004
5T	Organization Verification - Insufficient Data Start: 01/01/2004
5U	Individual Data Dissemination - Fulfilled Start: 01/01/2004
5V	Individual Data Dissemination - Not Fulfilled Start: 01/01/2004
5W	Organization Data Dissemination - Fulfilled Start: 01/01/2004
5X	Organization Data Dissemination - Not Fulfilled Start: 01/01/2004
5Y	Unspecified Response Start: 01/01/2004