Permission to Use and Distribute the Health Care Provider Characteristics and Resources Code Set

The American Medical Association (AMA) on behalf of the National Uniform Claim Code Committee (NUCC) grants you and your organization (you) a non-exclusive, royalty-free, non-transferable permission to use and distribute the Health Care Provider Characteristics and Resources Code Set (Provider Characteristics) that includes the AMA's copyright notice and is posted on www.nucc.org and to incorporate and distribute the Provider Taxonomy in your products in the United States (Products) subject to the following agreements:

  1. In consideration of this permission, you will not change the Provider Characteristics (except for format and stylistic changes necessary to incorporate the Provider Characteristics in the Products) or create derivative works of the Provider Characteristics;
  2. You acknowledge the AMA holds copyright in the Provider Characteristics on behalf of the NUCC and you will include all notices, disclaimers and attribution statements as included in the Provider Characteristics on any copy of the Provider Characteristics;
  3. You may not use the name of the AMA, the NUCC, or any of the NUCC members in the promotion of your Products other than to state that the Products include the Provider Characteristics without any statement or implication of endorsement of your Products;
  4. You acknowledge that the Provider Characteristics is provided "AS IS" without warranty of any kind;
  5. You agree that the neither the AMA, the NUCC, nor any of the NUCC members shall be responsible for any consequences, including liability or damage attributable to or related to any use, non-use, or interpretation of information contained or not contained in the Provider Characteristics;
  6. You acknowledge that the Provider Characteristics is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable, which were developed exclusively at private expense by the NUCC and the American Medical Association, 515 North State Street, Chicago, Illinois, 60654. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.
  7. You shall only license the Provider Characteristics in your Products to third parties consistent with the terms of this Permission;
  8. Any use not authorized is not permitted and the AMA may terminate this permission if you violate its terms; and
  9. This permission shall be governed by Illinois law without regard to choice of law principles and shall remain in effect for three years from your date of acceptance.

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Health Care Provider Characteristics Codes CSV

The current version of the Health Care Provider Characteristics Codes as a Comma Separated Values (CSV) file:

For commercial use, including sales or licensing, a license must be obtained from this web site.

Health Care Provider Characteristics Codes Help

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Health Care Provider Characteristics Codes

10 Provider has a medical condition that impairs or limits him/her to practice
Start: 01/01/2004
11 Provider receives public funding
Start: 01/01/2004
13 This is a primary care group
Start: 01/01/2004
14 Provider has ownership or financial interest in another medical establishment
Start: 01/01/2004
15 Professional liability coverage has been restricted/terminated/or modified
Start: 01/01/2004
16 This is the provider's primary insurance coverage
Start: 01/01/2004
17 This is the provider's excess insurance coverage
Start: 01/01/2004
18 Excess insurance coverage exists for this provider
Start: 01/01/2004
19 Provider is self-insured
Start: 01/01/2004
1A Provider's self-insurance is funded
Start: 01/01/2004
1B Provider's self-insurance is not funded
Start: 01/01/2004
1C Provider has had adverse action on state license, certificate, or registration
Start: 01/01/2004
1D Provider has had adverse action on DEA or other applicable narcotic registration
Start: 01/01/2004
1E Provider has had adverse action on hospital or other health care facility staff membership for privileges
Start: 01/01/2004
1F Provider has had adverse action on professional organization membership
Start: 01/01/2004
1G Provider has had adverse action on Medicare, Medicaid or other government health programs
Start: 01/01/2004
1H Provider has had adverse action on any prepaid health plan or managed care participation
Start: 01/01/2004
1I Provider has had adverse action with respect to educational or training institution or program
Start: 01/01/2004
1J Provider has had adverse action by professional society or association
Start: 01/01/2004
1K Provider is under health plan administrative sanction
Start: 01/01/2004
1L Provider accepts Workers' Compensation
Start: 01/01/2004
1M Provider accepts Medicare assignment
Start: 01/01/2004
1N Provider accepts Medicaid assignment
Start: 01/01/2004
1O Provider participates in Medicare and accepts assignment
Start: 01/01/2004
1P Provider participates in Medicaid and accepts assignment
Start: 01/01/2004
1Q Provider is not accepting new patients for obstetric care
Start: 01/01/2004
1R This location is handicapped accessible
Start: 01/01/2004
1S This location is less than 1 block from public transportation
Start: 01/01/2004
1T This location is less than 5 blocks from public transportation
Start: 01/01/2004
1U This location is less than 1 mile from public transportation
Start: 01/01/2004
1V This location is 1 or more miles from public transportation
Start: 01/01/2004
1W This location has a full time assistant available
Start: 01/01/2004
1X This location has a part time assistant available
Start: 01/01/2004
1Y This location has Telecommunication Device for the Deaf (TDD) equipment
Start: 01/01/2004
1Z This location is medically fragile equipped
Start: 01/01/2004
20 This location employs para-professional staff/employees
Start: 01/01/2004
21 This location maintains para-professional credentialing, licensure & malpractice information
Start: 01/01/2004
22 This location admits and cares for patients on its own hospital service
Start: 01/01/2004
23 The scheduling time for urgent care at this location is more than 24 hours
Start: 01/01/2004
24 The scheduling time for symptomatic care at this location is more than 72 hours
Start: 01/01/2004
25 The scheduling time for routine visits at this location is more than 7 days
Start: 01/01/2004
26 The scheduling time for preventive routine care at this location is more than 30 days
Start: 01/01/2004
27 The waiting time at this location is more than 30 minutes from time of scheduled appointment
Start: 01/01/2004
28 Allergy skin testing is provided at this location
Start: 01/01/2004
29 Asthma treatment is provided at this location
Start: 01/01/2004
2A EKG services are provided at this location
Start: 01/01/2004
2B Flexible sigmoidoscopy is provided at this location
Start: 01/01/2004
2C IV hydration/treatment is provided at this location
Start: 01/01/2004
2D Laceration repair is provided at this location
Start: 01/01/2004
2E Laboratory services/testing is provided at this location
Start: 01/01/2004
2F Massage therapy is provided at this location
Start: 01/01/2004
2G Minor fracture work is provided at this location
Start: 01/01/2004
2H Minor surgery is provided at this location
Start: 01/01/2004
2I Occupational therapy is provided at this location
Start: 01/01/2004
2J Gynecology services are provided at this location
Start: 01/01/2004
2K Obstetric services are provided at this location
Start: 01/01/2004
2L Osteopathic manipulation is provided at this location
Start: 01/01/2004
2M Physical therapy is provided at this location
Start: 01/01/2004
2N Pulmonary function studies are provided at this location
Start: 01/01/2004
2O Speech pathology is provided at this location
Start: 01/01/2004
2P Hearing tests are provided at this location
Start: 01/01/2004
2Q Visual screenings are provided at this location
Start: 01/01/2004
2R Mammography services are provided at this location
Start: 01/01/2004
2S X-rays are provided at this location
Start: 01/01/2004
2T This hospital has a Medicare Prospective Payment System (PPS) exempt rehabilitation unit
Start: 01/01/2004
2U This hospital has a Medicare Prospective Payment System (PPS) exempt psychiatric unit
Start: 01/01/2004
2V Assistive aid information not collected from the provider
Start: 10/01/2006
55 Accepted
Start: 01/01/2004
56 Unspecified Error
Start: 01/01/2004
57 Failed Field Edits
Start: 01/01/2004
58 Minimum Fields Missing
Start: 01/01/2004
59 Exact Duplicate
Start: 01/01/2004
5A Rejected by NPI Enumerator
Start: 01/01/2004
5B Invalid Taxonomy Code
Start: 01/01/2004
5C Taxonomy Code Mismatch
Start: 01/01/2004
5D SSN Validation Error
Start: 01/01/2004
5E Mailing Address Error
Start: 01/01/2004
5F Location Address Error
Start: 01/01/2004
5G NPI not on File
Start: 01/01/2004
5H Invalid Deactivation Reason Code
Start: 01/01/2004
5I Pended by GateKeeper
Start: 01/01/2004
5J Pended by L/S/T
Start: 01/01/2004
5K Duplicate record
Start: 01/01/2004
5L Schema validation failed
Start: 01/01/2004
5M Individual Verification - Found
Start: 01/01/2004
5N Individual Verification - Not Found
Start: 01/01/2004
5O Individual Verification - Close Match
Start: 01/01/2004
5P Individual Verification - Insufficient Data
Start: 01/01/2004
5Q Organization Verification - Found
Start: 01/01/2004
5R Organization Verification - Not Found
Start: 01/01/2004
5S Organization Verification - Close Match
Start: 01/01/2004
5T Organization Verification - Insufficient Data
Start: 01/01/2004
5U Individual Data Dissemination - Fulfilled
Start: 01/01/2004
5V Individual Data Dissemination - Not Fulfilled
Start: 01/01/2004
5W Organization Data Dissemination - Fulfilled
Start: 01/01/2004
5X Organization Data Dissemination - Not Fulfilled
Start: 01/01/2004
5Y Unspecified Response
Start: 01/01/2004

Provider Characteristics Code Set

Code Set Resources

The following resources for the Provider Characteristics code set are available from the "Provider Characteristics" drop-down menu:

Code Lookup is the complete list of Health Care Provider Characteristics Codes.

Questions is where you can submit a question about the code set.

More Information is a list of FAQs about the code set and how to use it.

PDF is where you can view, save, and print a PDF version of the current code set.

CSV is where you can download a Comma Separated Values (CSV) version of the code set.

Vendors interested in incorporating the Provider Characteristics code set into their commercial products must complete the license request form found on the CSV page.

Background Information

The Provider Characteristics Code Set is for use with health care provider information for enrollment and credentialing transactions and their corresponding responses. It 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.

This is not intended to be a comprehensive list of services rendered by a health care provider.

This code set was formulated so that the absence of information is a meaningful statement and should describe the most common situation. (i.e. "2S" = x-rays are provided at this location. No data transmitted means x-rays are not provided, "2S" transmitted means x-rays are provided.) New statements should follow this guideline and should be screened so that conflicting information is not introduced (do not add "provider is participating" AND "provider is not participating". Select the least common statement to add to the list).

Code Request/Change Criteria

To request new codes or modifications to existing codes, send an email to: This email address is being protected from spambots. You need JavaScript enabled to view it..