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TMSIS Dataguide Medicaid.gov

Version:

PROV-CLASSIFICATION-CODE

Data Element

DE Number

PRV089

System DE Number

PRV.006.089

File Name

PRV - PROVIDER

File Segment Number

PRV00006

File Segment Name

PROV-TAXONOMY-CLASSIFICATION

Last updated

Definition The code values from the categorization schema identified in the Provider Classification Type data element. Note: States should apply these classification schemas consistently across all providers.
Size X(20)
FLF Start Position 53
FLF Stop Position 72
Segment Key Field Identifier 4
Coding Requirements 1. Value must be 20 characters or less
2. If associated Provider Classification Type equals "1", value must be in Provider Taxonomy List (VVL)
3. If associated Provider Classification Type equals "2", value must be in Provider Specialty List (VVL)
4. If associated Provider Classification Type equals "3", value must be in Provider Type Code List (VVL)
5. If associated Provider Classification Type equals "4", value must be in Provider Classification Code Type 4 List (VVL)
6. Mandatory
Valid Value Code Set Valid Value Code Valid Value Name Valid Value Description Effective Start Date Effective End Date
DE Number System DE Number DE Name File Segment Number File Segment Name