07/15/2025

On claims for our Medicaid members, ensure you’re reporting the correct taxonomy code for the rendering provider. Claims with missing or invalid taxonomy codes are resulting in denials or payment delays.

What you can do: Report the correct taxonomy code using the "ZZ" qualifier on CMS-1500 forms and in electronic submissions, particularly when the taxonomy code is not a National Provider Identifier. The taxonomy code must match what the state Medicaid agency has on file for the rendering provider's NPI, Atypical Provider Identifier and Tax ID. 

More details:

• CMS-1500 forms: Use the "ZZ" qualifier in the shaded area of 24I (if the number is not an NPI) to indicate the taxonomy code. The rendering provider's Other ID# should be in 24J. 
• Electronic submissions: Ensure the correct taxonomy code and Other ID# are reported in the appropriate fields. 
• Items 24I and 24J: These fields should only be populated when the information differs from what's in items 33a and 33b (billing provider information). 

If you have questions or need assistance, please reach out to our Medicaid Provider Network Team at 855-212-1615 or email.