There are two places in TherapyMate where you can add a Taxonomy Code for billing purposes. The article will show where you can add a code.
There are three scenarios for using Taxonomy Codes for billing purposes.
1. Clinician Taxonomy Code who is the rendering provider (Box 31)
2. Clinician Taxonomy Code when the Clinician is also the Billing Provider (Box 31 and Box 33B)
2. Group Taxonomy Code for the facility (Box 32B and 33B)
Clinician Taxonomy Setting who is the Rendering Provider
On a Clinician's Practice Information settings page there is a box called Clinician Taxonomy Code. If a taxonomy code is entered in the box, it will be included in electronic claims along with the Clinician's first and last name and NPI number. These will appear in Box 31 if you were looking at a visual representation of the claim. Make sure the taxonomy code you enter matches your licensure.
Clinician Taxonomy Setting when the Clinician is also the Billing Provider
There are situations where a clinician is the rendering provider (Box31) AND the billing provider (Box 33B) and you use the same taxonomy code in each settings location.
For example, if you are registered with the insurance provider under you name and NOT a Practice name or Organization this may apply to you.
First, put your Taxonomy Code in your Clinician Practice Information page as shown above.
Second, go to an insurance provider who is looking for your Taxonomy Code in the Billing Provider Box 33B and configure the settings las follows:
1. Leave the Entity type qualifier as Non-Person Entity
2. Default NPI for Billing Purposes as Group NPI
3. Enter your Clinician Taxonomy Code in the next box
4. Choose PXC-Provider Taxonomy 5010A1 from the Box 32B and 33B drop downs.
5. Box24J is only used for CMS-1500s. Set it to "No"
6. Go to your Clinician Profile Information page and enter your Clinician Taxonomy Code in the Group NPI Box.
In this scenario, the Group NPI and Clinician NPI boxes will be the same.
Group Taxonomy Setting
There is a place to put the facility's taxonomy code on each Insurance Provider's settings page. Not all insurance providers require the code. Check with the provider if you have questions.
Here is a typical example of an insurance provider that requires the taxonomy code.
1. Your billing as a group practice using your group NPI number
2. The entity type would be non-person.
3. The group taxonomy code goes in the Taxonomy Code box. This code should match what the insurance provider has in their records.
4. When the code is entered in the taxonomy code box, the Box 32B (service facility) and Box 33B (billing provider) qualifier drop downs will appear. For electronic claims choose PXC-Provider Taxonomy 5010A1 for both.
This information will be included in your electronic claim files when you create them. If the clinician added their taxonomy code in their settings that will be include also in Box 31.