Appendix Table 1:
Medicare provider specialty codes and specialty group cross-walk
| HCFA Specialty Code | Description | Specialty Group | Specialty Group Description |
|---|---|---|---|
| 00 | Carrier wide | ZZ | Non-surgical specialty |
| 01 | General practice | ZZ | Non-surgical specialty |
| 02 | General surgery | 02 | General surgery |
| 03 | Allergy/immunology | ZZ | Non-surgical specialty |
| 04 | Otolaryngology | 04 | Otolaryngology |
| 05 | Anesthesiology | 05 | Anesthesiology |
| 06 | Cardiology | 06 | Cardiology |
| 07 | Dermatology | ZZ | Non-surgical specialty |
| 08 | Family practice Interventional Pain Management (IPM) | ZZ | Non-surgical specialty |
| 09 | (eff. 4/1/03) | 05 | Anesthesiology |
| 10 | Gastroenterology | 10 | Gastroenterology |
| 11 | Internal medicine | ZZ | Non-surgical specialty |
| 12 | Osteopathic manipulative therapy | ZZ | Non-surgical specialty |
| 13 | Neurology | ZZ | Non-surgical specialty |
| 14 | Neurosurgery | 14 | Neurosurgery |
| 15 | Obstetrics (osteopaths only) (discontinued 5/92 use code 16) | 16 | Obstetrics/gynecology |
| 16 | Obstetrics/gynecology | 16 | Obstetrics/gynecology |
| 17 | Ophthalmology, otology, laryngology, rhinology (osteopaths only) (discontinued 5/92 use codes 18 or 04 depending on percentage of practice) | 18 | Ophthalmology |
| 18 | Ophthalmology | 18 | Ophthalmology |
| 19 | Oral surgery (dentists only) | 85 | Maxillofacial surgery (eff 5/92) |
| 20 | Orthopedic surgery | 20 | Orthopedic surgery |
| 21 | Pathologic anatomy, clinical pathology (osteopaths only) (discontinued 5/92 use code 22) | ZZ | Non-surgical specialty |
| 22 | Pathology | ZZ | Non-surgical specialty |
| 23 | Peripheral vascular disease, medical or surgical (osteopaths only) (discontinued 5/92 use code 76) | 77 | Vascular surgery (eff 5/92) |
| 24 | Plastic and reconstructive surgery | 24 | Plastic and reconstructive surgery |
| 25 | Physical medicine and rehabilitation | ZZ | Non-surgical specialty |
| 26 | Psychiatry | ZZ | Non-surgical specialty |
| 27 | Psychiatry, neurology (osteopaths only) (discontinued 5/92 use code 86) | ZZ | Non-surgical specialty |
| 28 | Colorectal surgery (formerly proctology) | 28 | Colorectal surgery (formerly proctology) |
| 29 | Pulmonary disease | ZZ | Non-surgical specialty |
| 30 | Diagnostic radiology | ZZ | Non-surgical specialty |
| 31 | Roentgenology, radiology (osteopaths only) (discontinued 5/92 use code 30) Anesthesiologist Assistants (eff. 4/1/03--previously grouped with | ZZ | Non-surgical specialty |
| 32 | Certified Registered Nurse Anesthetists (CRNA)) | ZZ | Non-surgical specialty |
| 33 | Thoracic surgery | 33 | Thoracic surgery |
| 34 | Urology | 34 | Urology |
| 35 | Chiropractic | ZZ | Non-surgical specialty |
| 36 | Nuclear medicine | ZZ | Non-surgical specialty |
| 37 | Pediatric medicine | ZZ | Non-surgical specialty |
| 38 | Geriatric medicine | ZZ | Non-surgical specialty |
| 39 | Nephrology | ZZ | Non-surgical specialty |
| 40 | Hand surgery | 40 | Hand surgery |
| 41 | Optometry (revised 10/93 to mean optometrist) | ZZ | Non-surgical specialty |
| 42 | Certified nurse midwife (eff 1/87) | ZZ | Non-surgical specialty |
| 43 | CRNA (eff. 1/87) (Anesthesiologist Assistants were removed from this specialty 4/1/03) | ZZ | Non-surgical specialty |
| 44 | Infectious disease | ZZ | Non-surgical specialty |
| 45 | Mammography screening center | ZZ | Non-surgical specialty |
| 46 | Endocrinology (eff 5/92) | ZZ | Non-surgical specialty |
| 47 | Independent Diagnostic Testing Facility (IDTF) (eff. 6/98) | ZZ | Non-surgical specialty |
| 48 | Podiatry | ZZ | Non-surgical specialty |
| 49 | Ambulatory surgical center (formerly miscellaneous) | ZZ | Non-surgical specialty |
| 50 | Nurse practitioner | ZZ | Non-surgical specialty |
| 51 | Medical supply company with certified orthotist (certified by American Board for Certification in Prosthetics And Orthotics) | ZZ | Non-surgical specialty |
| 52 | Medical supply company with certified prosthetist (certified by American Board for Certification In Prosthetics And Orthotics) | ZZ | Non-surgical specialty |
| 53 | Medical supply company with certified prosthetist- orthotist (certified by American Board for Certification in Prosthetics andOrthotics) | ZZ | Non-surgical specialty |
| 54 | Medical supply company not included in 51, 52, or 53. (Revised 10/93 to mean medical supply company for DMERC) | ZZ | Non-surgical specialty |
| 55 | Individual certified orthotist | ZZ | Non-surgical specialty |
| 56 | Individual certified prosthetist | ZZ | Non-surgical specialty |
| 57 | Individual certified prosthetist-orthotist | ZZ | Non-surgical specialty |
| 58 | Individuals not included in 55, 56, or 57, (revised 10/93 to mean medical supply company with registered pharmacist) | ZZ | Non-surgical specialty |
| 59 | Ambulance service supplier, e.g., private ambulance companies, funeral homes, etc. | ZZ | Non-surgical specialty |
| 60 | Public health or welfare agencies (federal, state, and local) | ZZ | Non-surgical specialty |
| 61 | Voluntary health or charitable agencies (e.g. National Cancer Society, National Heart Association, Catholic Charities) | ZZ | Non-surgical specialty |
| 62 | Psychologist (billing independently) | ZZ | Non-surgical specialty |
| 63 | Portable X-ray supplier | ZZ | Non-surgical specialty |
| 64 | Audiologist (billing independently) | ZZ | Non-surgical specialty |
| 65 | Physical therapist (private practice added 4/1/03) (independently practicing removed 4/1/03) | ZZ | Non-surgical specialty |
| 66 | Rheumatology (eff 5/92) Note: during 93/94 DMERC also used this to mean medical supply company with respiratory therapist | ZZ | Non-surgical specialty |
| 67 | Occupational therapist (private practice added 4/1/03) (independently practicing removed 4/1/03) | ZZ | Non-surgical specialty |
| 68 | Clinical psychologist | ZZ | Non-surgical specialty |
| 69 | Clinical laboratory (billing independently) | ZZ | Non-surgical specialty |
| 70 | Multispecialty clinic or group practice | ZZ | Non-surgical specialty |
| 71 | Registered Dietician/Nutrition Professional (eff. 1/1/02) | ZZ | Non-surgical specialty |
| 72 | Pain Management (eff. 1/1/02) | ZZ | Non-surgical specialty |
| 73 | Mass Immunization Roster Biller (eff. 4/1/03) | ZZ | Non-surgical specialty |
| 74 | Radiation Therapy Centers (added to differentiate them from Independent Diagnostic Testing Facilities (IDTF -eff. 4/1/03) | ZZ | Non-surgical specialty |
| 75 | Slide Preparation Facilities (added to differentiate them from Independent Diagnostic Testing Facilites (IDTFs -eff. 4/1/03) | ZZ | Non-surgical specialty |
| 76 | Peripheral vascular disease (eff 5/92) | 77 | Vascular surgery (eff 5/92) |
| 77 | Vascular surgery (eff 5/92) | 77 | Vascular surgery (eff 5/92) |
| 78 | Cardiac surgery (eff 5/92) | 78 | Cardiac surgery (eff 5/92) |
| 79 | Addiction medicine (eff 5/92) | ZZ | Non-surgical specialty |
| 80 | Licensed clinical social worker | ZZ | Non-surgical specialty |
| 81 | Critical care (intensivists) (eff 5/92) | ZZ | Non-surgical specialty |
| 82 | Hematology (eff 5/92) | ZZ | Non-surgical specialty |
| 83 | Hematology/oncology (eff 5/92) | ZZ | Non-surgical specialty |
| 84 | Preventive medicine (eff 5/92) | ZZ | Non-surgical specialty |
| 85 | Maxillofacial surgery (eff 5/92) | 85 | Maxillofacial surgery (eff 5/92) |
| 86 | Neuropsychiatry (eff 5/92) | ZZ | Non-surgical specialty |
| 87 | All other suppliers (e.g. drug and department stores) (note: DMERC used 87 to mean department store from 10/93 through 9/94; recoded eff 10/94 to A7; NCH cross-walked DMERC reported 87 to A7. | ZZ | Non-surgical specialty |
| 88 | Unknown supplier/provider specialty (note: DMERC used 87 to mean grocery store from 10/93 – 9/94; recoded eff 10/94 to A8; NCH cross- walked DMERC reported 88 to A8. | ZZ | Non-surgical specialty |
| 89 | Certified clinical nurse specialist | ZZ | Non-surgical specialty |
| 90 | Medical oncology (eff 5/92) | ZZ | Non-surgical specialty |
| 91 | Surgical oncology (eff 5/92) | 91 | Surgical oncology (eff 5/92) |
| 92 | Radiation oncology (eff 5/92) | ZZ | Non-surgical specialty |
| 93 | Emergency medicine (eff 5/92) | ZZ | Non-surgical specialty |
| 94 | Interventional radiology (eff 5/92) | 94 | Interventional radiology (eff 5/92) |
| 95 | Competative Acquisition Program (CAP) Vendor (eff. 07/01/06). Prior to 07/01/06, known as Independent physiological laboratory (eff. 5/92) | ZZ | Non-surgical specialty |
| 96 | Optician (eff 10/93) | ZZ | Non-surgical specialty |
| 97 | Physician assistant (eff 5/92) | ZZ | Non-surgical specialty |
| 98 | Gynecologist/oncologist (eff 10/94) | 16 | Obstetrics/gynecology |
| 99 | Unknown physician specialty | ZZ | Non-surgical specialty |
| A0 | Hospital (eff 10/93) (DMERCs only) | ZZ | Non-surgical specialty |
| A1 | SNF (eff 10/93) (DMERCs only) | ZZ | Non-surgical specialty |
| A2 | Intermediate care nursing facility (eff 10/93) (DMERCs only) | ZZ | Non-surgical specialty |
| A3 | Nursing facility, other (eff10/93) (DMERCs only) | ZZ | Non-surgical specialty |
| A4 | HHA (eff 10/93) (DMERCs only) | ZZ | Non-surgical specialty |
| A5 | Pharmacy (eff 10/93) (DMERCs only) | ZZ | Non-surgical specialty |
| A6 | Medical supply company with respiratory therapist (eff 10/93) (DMERCs only) | ZZ | Non-surgical specialty |
| A7 | Department store (for DMERC use: eff 10/94, but cross- walked from code 87 eff 10/93) | ZZ | Non-surgical specialty |
| A8 | Grocery store (for DMERC use: eff 10/94, but cross- walked from code 88 eff 10/93) | ZZ | Non-surgical specialty |
| A9 | Indian Health Service (IHS), tribe and tribal organizations (nonhospital or nonhospital based facilities. DMERC s shall process claims submitted by IHS, tribe and nontribal organizations for DMEPOS and drugs covered by the DMERCs. (eff. 1/2005) | ZZ | Non-surgical specialty |
| B1 | Supplier of oxygen and/or oxygen related equipment (eff. 10/2/07) | ZZ | Non-surgical specialty |
| B2 | Pedorthic Personnel (eff. 10/2/07) | ZZ | Non-surgical specialty |
| B3 | Medical Supply Company with Pedorthic Personnel (eff. 10/2/07) | ZZ | Non-surgical specialty |
| B4 | Rehabilitation Agency (eff. 10/2/07) | ZZ | Non-surgical specialty |