Demos
Others titles
- Health Insurance Portability and Accountability Act (HIPAA) standard electronic transactions
- Medicare appropriate Health Care Provider Characteristics Codes
- Healthcare Provider Characteristics Codes and health care provider information
- Healthcare Application Inquiries
- Health Code and Health Care Provider Characteristics Codes
Keywords
- Healthcare Provider Characteristics Codes
- healthcare provider information
- HCPCS Codes credentialing transactions
- HCPC code enrollment and credentialing transactions
- responses to health application inquiries
- responses to health application registrations
- Health Code
Health Care Provider Characteristics Codes
This Healthcare Provider Characteristics Codes list is for use with health care provider information for enrollment and credentialing transactions and their corresponding responses. This dataset also contains information on the different provider characteristics codes and their descriptions, the start and modified dates and the status of each code.
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Description
Healthcare Provider Characteristics Codes is intended to provide codified responses to questions presented to a health care provider applying to or registering with an entity and to report the outcome of such application or registration. It may also be used for responses to inquiries regarding provider participation or registration in a program or plan.
The Centers for Medicare & Medicaid Services (CMS) maintain and annually update a List of Current Procedural Terminology (CPT) / Healthcare Common Procedure Coding System (HCPCS) Codes (Code List), which identifies all the items and services included within certain DHS categories. CMS updates the Code List to conform the list to the most recent publications of CPT and HCPCS and to account for changes in Medicare coverage and payment policies. The updated Code List is published in the Federal Register as an addendum to the annual Physician Fee Schedule final rule. That rule is usually published in November and generally becomes effective January 1 of the following year. In addition, we may publish other rules or correction notices that may change the Code List. CMS posts any changes to the Code List on its webpage as soon as possible after publication in the Federal Register.
The DHS categories defined by the Code List are:
– Clinical laboratory services;
– Physical therapy services, occupational therapy services, outpatient speech-language pathology services;
– Radiology and certain other imaging services; and
– Radiation therapy services and supplies.
**NOTE**: The following DHS categories are defined at 42 CFR §411.351 without reference to the Code List:
– Durable medical equipment and supplies;
– Parenteral and enteral nutrients, equipment and supplies;
– Prosthetics, orthotics, and prosthetic devices and supplies;
– Home health services;
– Outpatient prescription drugs; and
– Inpatient and outpatient hospital services.
About this Dataset
Data Info
| Date Created | 2004-01-01 |
|---|---|
| Last Modified | 2019-01-01 |
| Version | 2019-01-01 |
| Update Frequency |
Irregular |
| Temporal Coverage |
2004 to 2015 |
| Spatial Coverage |
United States |
| Source | John Snow Labs; Centers of Medicare and Medicaid Services (CMS); |
| Source License URL | |
| Source License Requirements |
N/A |
| Source Citation |
N/A |
| Keywords | Healthcare Provider Characteristics Codes, healthcare provider information, HCPCS Codes credentialing transactions, HCPC code enrollment and credentialing transactions, responses to health application inquiries, responses to health application registrations, Health Code |
| Other Titles | Health Insurance Portability and Accountability Act (HIPAA) standard electronic transactions, Medicare appropriate Health Care Provider Characteristics Codes, Healthcare Provider Characteristics Codes and health care provider information, Healthcare Application Inquiries, Health Code and Health Care Provider Characteristics Codes |
Data Fields
| Name | Description | Type | Constraints |
|---|---|---|---|
| Code | Healthcare Provider Characteristics Codes | string | required : 1unique : 1 |
| Description | Description for each Healthcare Provider Characteristics Code | string | required : 1 |
| Start_Date | Date the Healthcare Provider Characteristics Code started usage | date | required : 1 |
| Stop_Date | Date the Healthcare Provider Characteristics Code was deactivated/stopped | date | - |
| Status | Code update whether Active, To be Deactivated or Deactivated | string | required : 1 |
| Notes | Provides other explanations and/or information about the Health Care Provider Characteristics Code | string | - |
Data Preview
| Code | Description | Start Date | Stop Date | Status | Notes |
| 10 | Provider has a medical condition that impairs or limits him/her to practice | 2004-01-01 | Active | ||
| 11 | Provider receives public funding | 2004-01-01 | Active | ||
| 12 | This is a multi-specialty group | 2004-01-01 | 2005-10-01 | Deactivated | |
| 13 | This is a primary care provider | 2004-01-01 | Active | ||
| 14 | Provider has ownership or financial interest in another medical establishment | 2004-01-01 | Active | ||
| 15 | Professional liability coverage has been restricted/terminated/or modified | 2004-01-01 | Active | ||
| 16 | This is the providerâs primary insurance coverage | 2004-01-01 | Active | ||
| 17 | This is the providerâs excess insurance coverage | 2004-01-01 | Active | ||
| 18 | Excess insurance coverage exists for this provider | 2004-01-01 | Active | ||
| 19 | Provider is self-insured | 2004-01-01 | Active |
