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Short SAS Name
OT_PHYSN_SPCLTY_CD
SAS Name
OT_PHYSN_SPCLTY_CD

The code used to identify the CMS specialty code corresponding to the other physician. 

Comments

The Affordable Care Act (ACA) provides for incentive payments for physicians and non-physician practitioners with specific primary specialty designations. In order to determine if the physician or non-physician is eligible for the incentive payment, the specialty code, NPI and name must be carried on the claims.

Source: NCH

 

CodeCode value
00
Carrier wide
01
General practice
02
General surgery
03
Allergy/immunology
04
Otolaryngology
05
Anesthesiology
06
Cardiology
07
Dermatology
08
Family practice
09
Interventional Pain Management (IPM) (eff. 4/1/03)
10
Gastroenterology
11
Internal medicine
12
Osteopathic manipulative therapy
13
Neurology
14
Neurosurgery
15
Speech / language pathology
16
Obstetrics/gynecology
17
Hospice and Palliative Care
18
Ophthalmology
19
Oral surgery (dentists only)
20
Orthopedic surgery
21
Cardiac Electrophysiology
22
Pathology
24
Plastic and reconstructive surgery
25
Physical medicine and rehabilitation
26
Psychiatry
27
General Psychiatry
28
Colorectal surgery (formerly proctology)
29
Pulmonary disease
30
Diagnostic radiology
31
Intensive cardiac rehabilitation
32
Anesthesiologist Assistants (eff. 4/1/03—previously grouped with Certified Registered Nurse Anesthetists (CRNA))
33
Thoracic surgery
34
Urology
35
Chiropractic
36
Nuclear medicine
37
Pediatric medicine
38
Geriatric medicine
39
Nephrology
40
Hand surgery
41
Optometrist
42
Certified nurse midwife
43
Certified Registered Nurse Anesthetist (CRNA) (Anesthesiologist Assistants were removed from this specialty 4/1/03)
44
Infectious disease
45
Mammography screening center
46
Endocrinology
47
Independent Diagnostic Testing Facility (IDTF)
48
Podiatry
49
Ambulatory surgical center (formerly miscellaneous)
50
Nurse practitioner
51
Medical supply company with certified orthotist (certified by American Board for Certification in Prosthetics and Orthotics)
52
Medical supply company with certified prosthetist (certified by American Board for Certification in Prosthetics and Orthotics)
53
Medical supply company with certified prosthetist-orthotist (certified by American Board for Certification in Prosthetics and Orthotics)
54
Medical supply company for DMERC (and not included in 51-53)
55
Individual certified orthotist
56
Individual certified prosthetist
57
Individual certified prosthetist-orthotist
58
Medical supply company with registered pharmacist
59
Ambulance service supplier, (e.g., private ambulance companies, funeral homes, etc.)
60
Public health or welfare agencies (federal, state, and local)
61
Voluntary health or charitable agencies (e.g. National Cancer Society, National Heart Association, Catholic Charities)
62
Psychologist (billing independently)
63
Portable X-ray supplier
64
Audiologist (billing independently)
65
Physical therapist (private practice added 4/1/03) (independently practicing removed 4/1/03)
66
Rheumatology
67
Occupational therapist (private practice added 4/1/03) (independently practicing removed 4/1/03)
68
Clinical psychologist
69
Clinical laboratory (billing independently)
70
Multispecialty clinic or group practice
71
Registered Dietician/Nutrition Professional (eff. 1/1/02)
72
Pain Management (eff. 1/1/02)
73
Pain Management (eff. 1/1/02)
74
Radiation Therapy Centers (prior to 4/2003 this included Independent Diagnostic Testing Facilities (IDTF)
75
Slide Preparation Facilities (added to differentiate them from Independent Diagnostic Testing Facilities (IDTFs -- eff. 4/1/03)
76
Peripheral vascular disease
77
Vascular surgery
78
Cardiac surgery
79
Addiction medicine
80
Licensed clinical social worker
81
Critical care (intensivists)
82
Hematology
83
Hematology/oncology
84
Preventive medicine
85
Maxillofacial surgery
86
Neuropsychiatry
87
All other suppliers (e.g. drug and department stores)
88
Unknown supplier/provider specialty
89
Certified clinical nurse specialist
90
Medical oncology
91
Surgical oncology
92
Radiation oncology
93
Emergency medicine
94
Interventional radiology
95
Competitive Acquisition Program (CAP) Vendor (eff. 07/01/06). Prior to 07/01/06, known as Independent physiological laboratory
96
Optician
97
Physician assistant
98
Gynecologist/oncologist
99
Unknown physician specialty
A0
Hospital (DMERCs only)
A1
SNF (DMERCs only)
A2
Intermediate care nursing facility (DMERCs only)
A3
Nursing facility, other (DMERCs only)
A4
Home Health Agency (DMERCs only)
A5
Pharmacy (DMERC)
A6
Medical supply company with respiratory therapist (DMERCs only)
A7
Department store (DMERC)
A8
Grocery store (DMERC)
A9
Indian Health Service (IHS), tribe and tribal organizations (non-hospital or non-hospital based facilities, eff. 1/2005)
B1
Supplier of oxygen and/or oxygen related equipment (eff. 10/2/07)
B2
Pedorthic Personnel (eff. 10/2/07)
B3
Medical Supply Company with pedorthic personnel (eff. 10/2/07)
B4
Does not meet definition of health care provider (e.g., Rehabilitation agency, organ procurement organizations, histocompatibility labs) (eff. 10/2/07)
B5
Ocularist
C0
Sleep medicine
C1
Centralized flu
C2
Indirect payment procedure
C3
Interventional cardiology
C5
Dentist (eff. 7/2016)