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Provider Type and Specialty Listing

Ambulance - 26
Specialty Code Description
261 Air Ambulance
268 Water Ambulance
510 Basic Life Support Statewide
511 Advanced Life Support Statewide
514 Basic Life Support Milwaukee County
515 Advanced Life Support Milwaukee County

Ambulatory Surgical Center (ASC) - 02
Specialty Code Description
020 Ambulatory Surgical Center

Anesthetist - 32
Specialty Code Description
094 CRNA
101 Anesthesiologist Assistant
900 Group

Audiologists - 20
Specialty Code Description
200 Audiologist
900 Group

Behavioral Treatment Benefit - 34
Specialty Code Description
400 Behavioral Treatment Licensed Supervisor
401 Behavioral Treatment Therapist
402 Behavioral Treatment Technician
403 Focused Treatment Licensed Supervisor
404 Focused Treatment Therapist

Case Management - 21
Specialty Code Description
080 Federally Qualified Health Center
751 Public Sector
752 Private Sector

Child Care Coordination - 62
Specialty Code Description
751 Public Sector
752 Private Sector

Chiropractor - 15
Specialty Code Description
150 Chiropractor
900 Group

Comprehensive Community Services - 82
Specialty Code Description
850 Regional Lead
851 Regional Non-Lead
852 Regional Pop/Shared/51.42
853 Non-Regional Matching Funds
854 Non-Regional DQA
855 Non-Regional Both

Community Recovery Services - 13
Specialty Code Description
130 Community Recovery Services

Crisis Intervention/CCS/CSP - 80
Specialty Code Description
650 Crisis Intervention
651 Community Support Program (CSP)
652 Comprehensive Community Services (CCS)
653 Crisis Intervention & CSP
654 Crisis Intervention & CCS
655 CSP & CCS
656 Crisis Intervention/CSP/CCS
657 Enhanced Crisis Intervention

Day Treatment - 67
Specialty Code Description
010 Inpatient/Outpatient Hospital
801 Mental Health Agency
802 Substance Abuse Agency
803 MH/SA Agency

Dentists - 27
Specialty Code Description
270 Endodontics
271 General Practice
272 Oral Surgery
273 Orthodonics
274 Pediatric Dentist
275 Periodontics
276 Oral Pathology
277 Prosthodontics
289 Dental Hygienist
900 Group

End Stage Renal Disease - 30
Specialty Code Description
300 Free Standing
301 Hospital Affiliated

Facility for the Developmentally Disabled (FDD) - 57
Specialty Code Description
700 SNR/ICF/FDD
702 Centers

Family Planning Clinic - 71
Specialty Code Description
083 Family Planning

Federally Qualified Health Clinic (FQHC) - 75
Specialty Code Description
080 Federally Qualified Health Center
081 Community Health Center

Food is Medicine - 68
Specialty Code Description
680 Medically Tailored Meals

HealthCheck - 72
Specialty Code Description
733 Case Management Only
734 Screener
735 Screener/Case Management

HealthCheck "Other Services" - 73
Specialty Code Description
740 Mental Health
741 Residential Care Center for Children/Group Home
742 WIC Agency
743 Pediatric Community Care

Hearing Instrument Specialist - 22
Specialty Code Description
220 Hearing Instrument Specialist
900 Group

High Cost Medically Complex Case Management - 63
Specialty Code Description
765 High Cost Medically Complex Case Management

HMOs & Other Managed Care Programs - 65
Specialty Code Description
780 Managed Care Payee Provider
781 Managed Care Assigned Provider

Home Health/Personal Care Agency - 05
Specialty Code Description
050 Home Health Agency
052 Personal Care Agency
053 Home Health/Personal Care Agency

Hospice - 06
Specialty Code Description
050 Home Health Agency
052 Personal Care Agency
061 Hospital
063 Free Standing
064 Nursing Home

Hospital - 01
Specialty Code Description
010 Inpatient/Outpatient Hospital

Independent Lab - 28
Specialty Code Description
280 Independent Lab
283 Blood Bank

Individual Medical Supply - 53
Specialty Code Description
540 Individual Orthotist
541 Individual Prosthetist
542 Individual Orthotist/Prosthetist
543 Other Individual Medical Supply

Institution for Mental Disease - 58
Specialty Code Description
010 Inpatient/Outpatient Hospital
712 AODA General Hospital
713 Psychiatric Hospital

Medical Equipment Vendors - 25
Specialty Code Description
250 Medical Equipment Vendors
251 Medical Supply Contractor
252 Complex Rehabilitation Technology Supplier

Licensed Midwife - 35
Specialty Code Description
350 Licensed Midwife

Mental Health and Substance Abuse Services - 11
Specialty Code Description
112 Licensed Psychologist (PhD)
117 Psychiatric Nurse
121 Licensed Psychotherapist
122 Alcohol & Other Drug Abuse Counselor
123 Certified Psychotherapist
125 Advanced Practice Nurse Prescriber
126 Qualified Treatment Trainee
801 Mental Health Agency
802 Substance Abuse Agency
803 MH/SA Agency
804 Intensive Outpatient Program (IOP)
900 Group

Narcotic Treatment Service - 52
Specialty Code Description
160 Registered Nurse 
161 Licensed Practical Nurse
532 Registered Alcohol and Drug Counselor (RADC)/NTS
900 Group

Nurse Practitioner - 09
Specialty Code Description
090 Certified Pediatric Nurse Practitioner
092 Certified Family Nurse Practitioner
093 Other Nurse Practitioner
095 Nurse Practitioner/Nurse Midwife
900 Group

Nurse Service - 16
Specialty Code Description
160 Registered Nurse
161 Licensed Practical Nurse
208 LPN/RCS
209 RN/RCS
212 Nurse Midwife

Nursing Facility - 03
Specialty Code Description
035 Skilled Nursing Facilty

Occupational Therapist - 78
Specialty Code Description
171 Occupational Therapist
174 Occupational Therapy Assistant
900 Group

Optician - 19
Specialty Code Description
190 Optician
191 SPEC Contractor

Optometrists - 18
Specialty Code Description
180 Optometrist
192 Therapeutic Pharmaceutical Agents
900 Group

Pharmacist - 23
Specialty Code Description
241 Pharmacist

Pharmacy - 24
Specialty Code Description
240 Pharmacy
080 Federally Qualified Health Center
081 Community Health Center

Physical Therapy - 77
Specialty Code Description
170 Physical Therapist
175 Physical Therapist Assistant
900 Group

Physician - 31
Specialty Code Description
310 Allergy & Immunology
311 Anesthesiology
312 Cardiovascular Disease
314 Dermatology
315 Emergency Medicine
316 Family Practice
317 Gastroenterology
318 General Practice
319 General Surgery
320 Geriatrics
322 Internal Medicine
324 Nephrology
325 Neurological Surgery
326 Neurology
327 Nuclear Medicine
328 Obstetrics and Gynecology
329 Oncology and Hematology
330 Ophthalmology
331 Orthopedic Surgery
332 Otolaryngology
333 Pathology
336 Physical Medicine and Rehab
337 Plastic Surgery
338 Proctology
339 Psychiatry
340 Pulmonary Disease
341 Radiology
342 Thoracic and Cardiovascular Surgery 
343 Urology
345 Pediatrician
354 Preventive Medicine

Physician Assistant - 10
Specialty Code Description
100 Physician Assistant

Physician Group - 33
Specialty Code Description
310 Allergy & Immunology
311 Anesthesiology
312 Cardiovascular Disease
314 Dermatology
315 Emergency Medicine
316 Family Practice
317 Gastroenterology
318 General Practice
319 General Surgery
320 Geriatrics
322 Internal Medicine
324 Nephrology
325 Neurological Surgery
326 Neurology
327 Nuclear Medicine
328 Obstetrics and Gynecology
329 Oncology and Hematology
330 Ophthalmology
331 Orthopedic Surgery
332 Otolaryngology
333 Pathology
336 Physical Medicine and Rehab
337 Plastic Surgery
338 Proctology
339 Psychiatry
340 Pulmonary Disease
341 Radiology
342 Thoracic and Cardiovascular Surgery
343 Urology
345 Pediatrician
354 Preventive Medicine
900 Group

Podiatrist - 14
Specialty Code Description
140 Podiatrist
900 Group

Portable X-Ray - 29
Specialty Code Description
291 Portable X-ray
292 Independent Diagnostic Testing Facility

Prenatal Care Coordination - 61
Specialty Code Description
751 Public Sector
752 Private Sector

Rehabilitation Agency - 04
Specialty Code Description
040 Restorative Care/Therapy

Residential Substance Use Disorder Treatment - 84
Specialty Code Description
856 Clinically Managed High Intensity
857 Clinically Managed Low Intensity
956 Institution for Mental Disease High-Intensity
957 Institution for Mental Disease Low-Intensity

Rural Health Clinic - 70
Specialty Code Description
184 Hospital Affiliated Clinic
185 Free Standing Clinic

School Based Services - 12
Specialty Code Description
770 CESA
771 School District

Speech-Language Pathology - 79
Specialty Code Description
173 SLP Master Level
176 SLP Bachelor Level
900 Group

Speech & Hearing Clinic - 74
Specialty Code Description
182 Speech and Hearing

Substance Use Disorder Health Home - 07
Specialty Code Description
070 Hub

Therapy Groups - 17
Specialty Code Description
900 Group

Transportation - 51
Specialty Code Description
520 Specialized Medical Vehicle

Waiver Aging and disability Support Agency - 40
Specialty Code Description
960 Aging and Disability Support Agency
993 Aging and Disability Support Facility

Waiver Community Services & Support - 41
Specialty Code Description
961 Education & Training Agency
962 Camp
964 Housing Counseling Agency
965 Personal Assistant, Teacher
973 Community Services & Support

Waiver Counseling & Therapeutic Services - 42
Specialty Code Description
966 Counseling & Therapeutic Services

Waiver Equipment & Accessibility Related Services - 43
Specialty Code Description
967 Accessibility Assessment
968 Medical Equipment & Supplies
989 Assistive, Communication, or Adaptive Aids
990 Support Broker

Waiver Financial Management - 45
Specialty Code Description
970 Financial Management

Waiver Health and Wellness - 99
Specialty Code Description
963 Fitness Center
997 Sexuality Education and Training
998 Wellness Provider
999 Personal Trainer

Waiver Interpreter - 46
Specialty Code Description
971 Interpreter

Waiver Living Environment Adaptation - 47
Specialty Code Description
972 Contractors – Licensed
974 Movers/Moving Company
975 Public Utilities
976 Real Estate Agency/Landlords

Waiver Microboard - 98
Specialty Code Description
992 Microboard

Waiver Non-Residential Day & Vocational Services - 48
Specialty Code Description
977 Non-Residential Day & Vocational Services
994 Non-Residential Day & Vocational Facility

Waiver Nurse Service - 49
Specialty Code Description
978 Nurse Service

Waiver Personal Emergency Response Systems - 91
Specialty Code Description
980 Personal Emergency Response Systems

Waiver Remote Monitoring and Support - 97
Specialty Code Description
995 Remote Support Provider
996 Technology Vendor

Waiver Residential Services - 92
Specialty Code Description
981 1-2 Bed Adult Family Home
982 3-4 Bed Adult Family Home
983 Community-Based Residential Facility
984 Residential Care Apartment Complex

Waiver Retail Store - 93
Specialty Code Description
985 Merchants, Stores & other Retailer

Waiver Transportation - 95
Specialty Code Description
987 Common Carrier/Mass Transit
991 Specialized Transport

Waiver Tribal Provider - 96
Specialty Code Description
988 Tribal Provider
 
 
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