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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 - Federally Qualified Health Clinic (FQHC) / Federally Qualified 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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