If PRVDR_CLSFCTN_SYS equals “2” (provider specialty code), then the values are: 87 = All Other Suppliers 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 = Advance Diagnostic Imaging 96 = Optician 97 = Physician Assistant 98 = Gynecological/Oncology 99 = Undefined physician type (provider is an MD) If PRVDR_CLSFCTN_SYS equals “3” (provider type code), then the values are: 01 = Physician 02 = Speech Language Pathologist 03 = Oral Surgery (Dentist only) 04 = Cardiac Rehabilitation and Intensive Cardiac Rehabilitation 05 = Anesthesiology Assistant 06 = Chiropractic 07 = Optometry 08 = Certified Nurse Midwife 09 = Certified Registered Nurse Anesthetist (CRNA) 10 = Mammography Center 11 = Independent Diagnostic Testing Facility (IDTF) 12 = Podiatry 13 = Ambulatory Surgical Center 14 = Nurse Practitioner 15 = Medical Supply Company with Orthotist 16 = Medical Supply Company with Prosthetist 17 = Medical Supply Company with Orthotist -Prosthetist 18 = Other Medical Supply Company 19 = Individual Certified Orthotist 20 = Individual Certified Prosthetist 21 = Individual Certified Prosthetist -Orthotist 22 = Medical Supply Company with Pharmacist 23 = Ambulance Service Provider 24 = Public Health or Welfare Agency 25 = Voluntary Health or Charitable Agency 26 = Psychologist, Clinical 27 = Portable X -Ray Supplier 28 = Audiologist 29 = Physical Therapist in Private Practice 30 = Occupational Therapist in Private Practice 31 = Clinical Laboratory 32 = Clinic or Group Practice 33 = Registered Dietitian or Nutrition Professional 34 = Mass Immunizer Roster Biller 35 = Radiation Therapy Center 36 = Slide Preparation Facility 37 = Licensed Clinical Social Worker 38 = Certified Clinical Nurse Specialist 39 = Advance Diagnostic Imaging 40 = Optician 41 = Physician Assistant 42 = Hospital -General 43 = Skilled Nursing Facility 44 = Intermediate Care Nursing Facility 45 = Other Nursing Facility 46 = Home Health Agency 47 = Pharmacy 48 = Medical Supply Company with Respiratory Therapist 49 = Department Store 50 = Grocery Store 51 = Indian Health Service facility 52 = Oxygen supplier 53 = Pedorthic personnel 54 = Medical supply company with pedorthic personnel 55 = Rehabilitation Agency 56 = Ocularist 57 = All Other If PRVDR_CLSFCTN_SYS equals “4” authorized categories of service codes), then the values are: 001 = Inpatient hospital services, other than services in an institution for mental diseases 002 = Outpatient hospital services 003 = Rural health clinic services 004 = Other ambulatory services furnished by a rural health clinic 005 = Professional laboratory services 006 = Technical laboratory services 007 = Professional radiological services 008 = Technical radiological services 009 = Nursing facility services for individuals age 21 or older (other than services in an institution for mental disease) 010 = Early and periodic screening and diagnosis and treatment (EPSDT) services 011 = Family planning services and supplies for individuals of child-bearing age 012 = Physicians' services 013 = Medical and surgical services of a dentist 014 = Outpatient substance abuse treatment services. 015 = Medical or other remedial care or services, other than physicians' services, provided by licensed practitioners within the scope of practice as defined under State law 016 = Home health services - Nursing services 017 = Home health services - Home health aide services 018 = Home health services - Medical supplies, equipment, and appliances suitable for use in the home 019 = Home health services - Physical therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services 020 = Home health services - Occupational therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services 021 = Home health services - Speech pathology and audiology services provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services 022 = Private duty nursing services 023 = Advanced practice nurse services 024 = Pediatric nurse 025 = Nurse-midwife service 026 = Nurse practitioner services 027 = Respiratory care for ventilator-dependent individuals 028 = Clinic services 029 = Dental services 030 = Physical therapy services (when not provided under home health services) 031 = Occupational therapy services (when not provided under home health services) 032 = Speech, hearing, and language disorders services (when not provided under home health services) 033 = Prescribed drugs 034 = Over-the-counter medications. 035 = Dentures 036 = Prosthetic devices 037 = Eyeglasses 038 = Hearing Aids 039 = Diagnostic services 040 = Screening services 041 = Preventive services 042 = Well-baby and well-childcare services as defined by the State. 043 = Rehabilitative services 044 = Inpatient hospital services for individuals age 65 or older in institutions for mental diseases 045 = Nursing facility services for individuals age 65 or older in institutions for mental diseases 046 = Intermediate care facility (ICF/IIDICF/IID) services 047 = Nursing facility services, other than in institutions for mental diseases 048 = Inpatient psychiatric services for individuals under age 21 049 = Outpatient mental health services, other than Outpatient substance abuse treatment services. This TOS includes services furnished in a State-operated mental hospital and including community-based services. 050 = Inpatient substance abuse treatment services and residential substance abuse treatment services. 051 = Personal care services 052 = Primary care case management services 053 = Targeted case management services 054 = Case Management services other than those that meet the definition of primary care case management services or targeted case management services 055 = Care coordination services. 056 = Transportation services 057 = Enabling services 058 = Services furnished in a religious nonmedical health care institution 059 = Skilled nursing facility services for individuals under age 21 060 = Emergency hospital services 061 = Critical access hospital services 062 = HCBS - Case management services 063 = HCBS - Homemaker services 064 = HCBS - Home health aide services 065 = HCBS - Personal care services 066 = HCBS - Adult day health services 067 = HCBS - Habilitation services 068 = HCBS - Respite care services 069 = HCBS - Day treatment or other partial hospitalization services, psychosocial rehabilitation services and clinic services (whether or not furnished in a facility) for individuals with chronic mental illness 070 = HCBS - Day Care 071 = HCBS - Training for family members 072 = HCBS - Minor modification to the home 073 = HCBS - Other services requested by the agency and approved by CMS as cost effective and necessary to avoid institutionalization 074 = HCBS - Expanded habilitation services - Prevocational services 075 = HCBS - Expanded habilitation services - Educational services 076 = HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment 077 = HCBS-65-plus - Case management services 078 = HCBS-65-plus - Homemaker services 079 = HCBS-65-plus - Home health aide services 080 = HCBS-65-plus - Personal care services 081 = HCBS-65-plus - Adult day health services 082 = HCBS-65-plus - Respite care services 083 = HCBS-65-plus - Other medical and social services 084 = Sterilizations 085 = Prenatal care and pre-pregnancy family planning services and supplies. 086 = Other Pregnancy-related Procedures 087 = Hospice services 088 = Any other health care services or items specified by the Secretary and not excluded under regulations. 115 = Residential care