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Welcome  » April 25, 2024 2:41 PM
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Alerts
  • Change Healthcare (CHC) has begun submitting some batch X12 electronic transactions to ForwardHealth. The volume of backlogged claims held by CHC and the amount of time it will take CHC to send them is unknown. Once claims are acquired from CHC, ForwardHealth will process them in the order received.

    Visit the Change Healthcare Service Interruption: Resources page for more information on the security incident and for ForwardHealth resources.

  • Multi-factor authentication (MFA) is now required for the secure ForwardHealth Portal. Providers are encouraged to refer to the ForwardHealth Multi-Factor Authorization Instruction Sheet for help setting up MFA preferences.
    Providers may contact their Portal account administrator or call the ForwardHealth Portal Help Desk at 866-908-1363. Note: This is a project-specific announcement and is not related to the Change Healthcare disruption.
pt_ps_codes_and_descriptions.html

Provider Type and Specialty Code Reference


  • A specialty code of 000 indicates that any specialties for the given provider type apply.
Provider Type/Specialty Code and Description
26/513 - Ambulance / Advanced Life Support Metro
26/515 - Ambulance / Advanced Life Support Milwaukee County
26/511 - Ambulance / Advanced Life Support Statewide
26/261 - Ambulance / Air Ambulance
26/512 - Ambulance / Basic Life Support Metro
26/514 - Ambulance / Basic Life Support Milwaukee County
26/510 - Ambulance / Basic Life Support Statewide
26/080 - Ambulance / Federally Qualified Health Center
26/268 - Ambulance / Water Ambulance
02/020 - Ambulatory Surgical Center (ASC)
32/101 - Anesthetist / Anesthesiologist Assistant
32/094 - Anesthetist / CRNA
32/900 - Anesthetist / Group
20/200 - Audiologist / Audiologist
20/900 - Audiologist / Group
21/080 - Case Management / Federally Qualified Health Center
21/752 - Case Management / Private Sector
21/751 - Case Management / Public Sector
15/150 - Chiropractor
15/900 - Chiropractor / Group
69/831 - Community Care Organization / Barron Co.
69/832 - Community Care Organization / Lacrosse Co.
69/833 - Community Care Organization / Milwaukee Co.
13/130 - Community Recovery Services
80/655 - Crisis Intervention/CCS/CSP / CSP and CCS
80/651 - Crisis Intervention/CCS/CSP / Community Support Program (CSP)
80/652 - Crisis Intervention/CCS/CSP / Comprehensive Community Services (CCS)
80/650 - Crisis Intervention/CCS/CSP / Crisis Intervention
80/654 - Crisis Intervention/CCS/CSP / Crisis Intervention & CCS
80/653 - Crisis Intervention/CCS/CSP / Crisis Intervention & CSP
80/656 - Crisis Intervention/CCS/CSP / Crisis Intervention/CSP/CCS
80/080 - Crisis Intervention/CCS/CSP / Federally Qualified Health Center
67/080 - Day Treatment / Federally Qualified Health Center
67/010 - Day Treatment / Inpatient/Outpatient Hospital
67/803 - Day Treatment / MH/SA Agency
67/801 - Day Treatment / Mental Health Agency
67/802 - Day Treatment / Substance Abuse Agency
27/289 - Dentist / Dental Hygienist
27/270 - Dentist / Endodontics
27/271 - Dentist / General Practice
27/900 - Dentist / Group
27/276 - Dentist / Oral Pathology
27/272 - Dentist / Oral Surgery
27/273 - Dentist / Orthodontics
27/274 - Dentist / Pediatric Dentist
27/275 - Dentist / Periodontics
27/277 - Dentist / Prosthodontics
30/080 - End Stage Renal Disease / Federally Qualified Health Center
30/300 - End Stage Renal Disease / Free Standing
30/301 - End Stage Renal Disease / Hospital Affiliated
57/702 - Facility for the Developmentally Disabled (FDD) / Centers
57/700 - Facility for the Developmentally Disabled (FDD) / SNF/ICF/FDD
71/083 - Family Planning Clinic / Family Planning
71/080 - Family Planning Clinic / Federally Qualified Health Center
75/080 - Tribal Federally Qualified Health Center
75/081 - Community Health Center
65/781 - HMOs & Other Managed Care Programs / Managed Care Assigned Provider
65/780 - HMOs & Other Managed Care Programs / Managed Care Payee Provider
73/742 - HealthCheck "Other Services" / WIC Agency
73/740 - HealthCheck "Other Services" / Mental Health
73/743 - HealthCheck "Other Services" / Pediatric Community Care
73/741 - HealthCheck "Other Services" / Residential Care Center for Children/Group Home
72/733 - HealthCheck (EPSDT) / Case Management Only
72/080 - HealthCheck (EPSDT) / Federally Qualified Health Center
72/734 - HealthCheck (EPSDT) / Screener
72/735 - HealthCheck (EPSDT) / Screener Case Management
22/900 - Hearing Instrument Specialist / Group
22/220 - Hearing Instrument Specialist
63/765 - High Cost Medically Complex Case Management / High Cost Case Management
05/080 - Home Health/Personal Care Agency / Federally Qualified Health Center
05/050 - Home Health/Personal Care Agency / Home Health Agency
05/053 - Home Health/Personal Care Agency
05/052 - Home Health/Personal Care Agency / Personal Care Agency
06/080 - Hospice / Federally Qualified Health Center
06/063 - Hospice / Free Standing
06/050 - Hospice / Home Health Agency
06/061 - Hospice / Hospital
06/064 - Hospice / Nursing Home
06/052 - Hospice / Personal Care Agency
01/010 - Hospital / Inpatient/Outpatient Hospital
28/283 - Independent Lab / Blood Bank
28/280 - Independent Lab / Independent Lab
53/080 - Individual Medical Supply / Federally Qualified Health Center
53/540 - Individual Medical Supply / Individual Orthotist
53/542 - Individual Medical Supply / Individual Orthotist/Prosthetist
53/541 - Individual Medical Supply / Individual Prosthetist
53/543 - Individual Medical Supply / Other Individual Medical Supply
58/712 - Institution for Mental Disease / AODA General Hospital
58/010 - Institution for Mental Disease / Inpatient/Outpatient Hospital
58/713 - Institution for Mental Disease / Psychiatric Hospital
25/080 - Medical Equipment Vendor / Federally Qualified Health Center
25/250 - Medical Equipment Vendor
25/251 - Medical Supply Contractor
64/030 - Medication Therapy Management (MTM) Vendor
11/125 - Mental Health and Substance Abuse Services / Advanced Practice Nurse Prescriber
11/122 - Mental Health and Substance Abuse Services / Alcohol and Other Drug Abuse Counselor
11/124 - Mental Health and Substance Abuse Services / Certified Psychotherapist
11/123 - Mental Health and Substance Abuse Services / Certified Psychotherapist with SAC
11/080 - Mental Health and Substance Abuse Services / Federally Qualified Health Center
11/900 - Mental Health and Substance Abuse Services / Group
11/112 - Mental Health and Substance Abuse Services / Licensed Psychologist (PhD)
11/120 - Mental Health and Substance Abuse Services / Licensed Psychotherapist
11/121 - Mental Health and Substance Abuse Services / Licensed Psychotherapist with SAC
11/803 - Mental Health and Substance Abuse Services / MH/SA Agency
11/801 - Mental Health and Substance Abuse Services / Mental Health Agency
11/117 - Mental Health and Substance Abuse Services / Psychiatric Nurse
11/802 - Mental Health and Substance Abuse Services / Substance Abuse Agency
52/900 - Narcotic Treatment Service / Group
52/161 - Narcotic Treatment Service / Licensed Practical Nurse
52/532 - Narcotic Treatment Service / Registered Alcohol and Drug Counselor (RADC)/NTS
52/160 - Narcotic Treatment Service / Registered Nurse
09/092 - Nurse Practitioner / Certified Family Nurse Practitioner
09/090 - Nurse Practitioner / Certified Pediatric Nurse Practitioner
09/900 - Nurse Practitioner / Group
09/095 - Nurse Practitioner / Nurse Practitioner/Nurse Midwife
09/093 - Nurse Practitioner / Other Nurse Practitioner
16/900 - Nurse Service / Group
16/208 - Nurse Service / LPN/RCS
16/161 - Nurse Service / Licensed Practical Nurse
16/212 - Nurse Service / Nurse Midwife
16/209 - Nurse Service / RN/RCS
16/160 - Nurse Service / Registered Nurse
03/035 - Nursing Facility / Skilled Nursing Facility
78/900 - Occupational Therapist / Group
78/171 - Occupational Therapist
78/174 - Occupational Therapist / Occupational Therapy Assistant
19/190 - Optician
19/191 - Optician / SPEC Contractor
18/900 - Optometrist / Group
18/180 - Optometrist / Optometrist
18/192 - Optometrist / Therapeutic Pharmaceutical Agents
24/240 - Pharmacy / Pharmacy
77/900 - Physical Therapy / Group
77/170 - Physical Therapy / Physical Therapist
77/175 - Physical Therapy / Physical Therapy Assistant
31/310 - Physician / Allergy & Immunology
31/311 - Physician / Anesthesiology
31/312 - Physician / Cardiovascular Disease
31/314 - Physician / Dermatology
31/315 - Physician / Emergency Medicine
31/316 - Physician / Family Practice
31/317 - Physician / Gastroenterology
31/318 - Physician / General Practice
31/319 - Physician / General Surgery
31/320 - Physician / Geriatrics
31/322 - Physician / Internal Medicine
31/324 - Physician / Nephrology
31/325 - Physician / Neurological Surgery
31/326 - Physician / Neurology
31/327 - Physician / Nuclear Medicine
31/328 - Physician / Obstetrics and Gynecology
31/329 - Physician / Oncology and Hematology
31/330 - Physician / Opthamology
31/331 - Physician / Orthopedic Surgery
31/332 - Physician / Otolaryngology
31/333 - Physician / Pathology
31/345 - Physician / Pediatrician
31/336 - Physician / Physical Medicine and Rehab
31/337 - Physician / Plastic Surgery
31/354 - Physician / Preventative Medicine
31/338 - Physician / Proctology
31/339 - Physician / Psychiatry
31/340 - Physician / Pulmonary Disease
31/341 - Physician / Radiology
31/342 - Physician / Thoracic and Cardiovascular Surgery
31/343 - Physician / Urology
10/100 - Physician Assistant / Physician Assistant
33/310 - Physician Group / Allergy & Immunology
33/311 - Physician Group / Anesthesiology
33/312 - Physician Group / Cardiovascular Disease
33/314 - Physician Group / Dermatology
33/315 - Physician Group / Emergency Medicine
33/316 - Physician Group / Family Practice
33/317 - Physician Group / Gastroenterology
33/318 - Physician Group / General Practice
33/319 - Physician Group / General Surgery
33/320 - Physician Group / Geriatrics
33/900 - Physician Group / Group
33/322 - Physician Group / Internal Medicine
33/324 - Physician Group / Nephrology
33/325 - Physician Group / Neurological Surgery
33/326 - Physician Group / Neurology
33/327 - Physician Group / Nuclear Medicine
33/328 - Physician Group / Obstetrics and Gynecology
33/329 - Physician Group / Oncology and Hematology
33/330 - Physician Group / Opthamology
33/331 - Physician Group / Orthopedic Surgery
33/332 - Physician Group / Otolaryngology
33/333 - Physician Group / Pathology
33/345 - Physician Group / Pediatrician
33/336 - Physician Group / Physical Medicine and Rehab
33/337 - Physician Group / Plastic Surgery
33/354 - Physician Group / Preventative Medicine
33/338 - Physician Group / Proctology
33/339 - Physician Group / Psychiatry
33/340 - Physician Group / Pulmonary Disease
33/341 - Physician Group / Radiology
33/342 - Physician Group / Thoracic and Cardiovascular Surgery
33/343 - Physician Group / Urology
14/900 - Podiatrist / Group
14/140 - Podiatrist
29/291 - Portable X-Ray
61/080 - Prenatal Care Coordination / Federally Qualified Health Center
61/752 - Prenatal Care Coordination / Private Sector
61/751 - Prenatal Care Coordination / Public Sector
04/080 - Rehabilitation Agency / Federally Qualified Health Center
04/040 - Rehabilitation Agency / Restorative Care/Therapy
70/185 - Rural Health Clinic / Free Standing Clinic
70/184 - Rural Health Clinic / Hospital Affiliated Clinic
12/770 - School Based Services / CESA
12/771 - School Based Services / School District
74/182 - Speech & Hearing Clinic / Speech and Hearing
79/900 - Speech-Language Pathology / Group
79/176 - Speech-Language Pathology / SLP Bachelor Level
79/173 - Speech-Language Pathology / SLP Master Level
17/900 - Therapy Group / Group
51/080 - Transportation / Federally Qualified Health Center
51/520 - Transportation / Specialized Medical Vehicle
 
 
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