HealthCare Provider Taxonomy Codes Lookup

Updated on July 01, 2023. Version 23.1

Healthcare Taxonomy Codes are used for a variety of reasons which include specialization of health care providers, classification, and type. The Healthcare Taxonomy Set is designed in a hierarchical order that consists of definitions, descriptions, and codes.

The taxonomy code set is updated and published semi annually in January and July of each year. The January publication is available to be used in April and the July release is available to be used in October of that year. The implementation period is the elapsed time between the release date and the effective date. This time allows for vendors, payers, and providers the chance to incorporate all changes into their platforms and systems.

Health Maintenance Organization - 302R00000X

(1) A form of health insurance in which its members prepay a premium for the HMO's health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model.

Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 20; (2) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 58

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