Claim Attending Physician Specialty Code

SAS Name
AT_PHYSN_SPCLTY_CD

This variable is the code used to identify the CMS specialty code corresponding to the attending physician.

Comments

This field was added to accommodate the Affordable Care Act (ACA) – for incentive payments to providers with specific primary care specialty designations. It was not populated before 2012. This field is not populated on Inpatient or Skilled Nursing claims. 

Source: NCH

Code Code value
00 Carrier wide
01 General practice
02 General surgery
03 Allergy/immunology
04 Otolaryngology
05 Anesthesiology
06 Cardiology
07 Dermatology
08 Family practice
09 Interventional Pain Management (IPM) (eff. 4/1/03)
10 Gastroenterology
11 Internal medicine
12 Osteopathic manipulative therapy
13 Neurology
14 Neurosurgery
15 Speech / language pathology
16 Obstetrics/gynecology
17 Hospice and Palliative Care
18 Ophthalmology
19 Oral surgery (dentists only)
20 Orthopedic surgery
21 Cardiac Electrophysiology
22 Pathology
24 Plastic and reconstructive surgery
25 Physical medicine and rehabilitation
26 Psychiatry
27 General Psychiatry
28 Colorectal surgery (formerly proctology)
29 Pulmonary disease
30 Diagnostic radiology
31 Intensive cardiac rehabilitation
32 Anesthesiologist Assistants (eff. 4/1/03—previously grouped with Certified Registered Nurse Anesthetists (CRNA))
33 Thoracic surgery
34 Urology
35 Chiropractic
36 Nuclear medicine
37 Pediatric medicine
38 Geriatric medicine
39 Nephrology
40 Hand surgery
41 Optometrist
42 Certified nurse midwife
43 Certified Registered Nurse Anesthetist (CRNA) (Anesthesiologist Assistants were removed from this specialty 4/1/03)
44 Infectious disease
45 Mammography screening center
46 Endocrinology
47 Independent Diagnostic Testing Facility (IDTF)
48 Podiatry
49 Ambulatory surgical center (formerly miscellaneous)
50 Nurse practitioner
51 Medical supply company with certified orthotist (certified by American Board for Certification in Prosthetics and Orthotics)
52 Medical supply company with certified prosthetist (certified by American Board for Certification in Prosthetics and Orthotics)
53 Medical supply company with certified prosthetist-orthotist (certified by American Board for Certification in Prosthetics and Orthotics)
54 Medical supply company for DMERC (and not included in 51-53)
55 Individual certified orthotist
56 Individual certified prosthetist
57 Individual certified prosthetist-orthotist
58 Medical supply company with registered pharmacist
59 Ambulance service supplier, (e.g., private ambulance companies, funeral homes, etc.)
60 Public health or welfare agencies (federal, state, and local)
61 Voluntary health or charitable agencies (e.g. National Cancer Society, National Heart Association, Catholic Charities)
62 Psychologist (billing independently)
63 Portable X-ray supplier
64 Audiologist (billing independently)
65 Physical therapist (private practice added 4/1/03) (independently practicing removed 4/1/03)
66 Rheumatology
67 Occupational therapist (private practice added 4/1/03) (independently practicing removed 4/1/03)
68 Clinical psychologist
69 Clinical laboratory (billing independently)
70 Multispecialty clinic or group practice
71 Registered Dietician/Nutrition Professional (eff. 1/1/02)
72 Pain Management (eff. 1/1/02)
73 Mass Immunization Roster Biller
74 Radiation Therapy Centers (prior to 4/2003 this included Independent Diagnostic Testing Facilities (IDTF)
75 Slide Preparation Facilities (added to differentiate them from Independent Diagnostic Testing Facilities (IDTFs -- eff. 4/1/03)
76 Peripheral vascular disease
77 Vascular surgery
78 Cardiac surgery
79 Addiction medicine
80 Licensed clinical social worker
81 Critical care (intensivists)
82 Hematology
83 Hematology/oncology
84 Preventive medicine
85 Maxillofacial surgery
86 Neuropsychiatry
87 All other suppliers (e.g. drug and department stores)
88 Unknown supplier/provider specialty
89 Certified clinical nurse specialist
90 Medical oncology
91 Surgical oncology
92 Radiation oncology
93 Emergency medicine
94 Interventional radiology
95 Competitive Acquisition Program (CAP) Vendor (eff. 07/01/06). Prior to 07/01/06, known as Independent physiological laboratory
96 Optician
97 Physician assistant
98 Gynecologist/oncologist
99 Unknown physician specialty
A0 Hospital (DMERCs only)