Billing Taxonomy Requirements for Local Health Departments and School-based Linked Health Centers Reminder
Date: 07/03/25
Services provided in a local health department or school-based linked health centers do not require authorization regardless of contracted status. We would like to remind Meridian Medicaid Plan and YouthCare HealthChoice providers to bill the appropriate taxonomy to ensure claims do not deny for authorization.
If you are registered with HFS as one of these provider types, please be sure to include the billing taxonomy as noted below.
HFS Provider Type | HFS Provider Type Description | Billing Taxonomy |
|---|---|---|
52 | Local Health Department | 261QH0100X |
56 | School-based Linked Health Center | 261QS1000X |
Billing taxonomy rules for paper claims are communicated in Box 33b of the CMS 1500 format.
EDI claims - Billing taxonomies are communicated as follows in the ASCX12 005010X222 health care claim professional (837) EDI transaction set.
Loop ID | Reference | Reference Name | Example Segment |
|---|---|---|---|
2000A BILLING PROVIDER HIERARCHICAL LEVEL | PRV03 | Provider Taxonomy Code | PRV*BI*PXC*261QH0100X |
For questions please contact Provider Services at 866-606-3700 or reach out to your Provider Engagement contact.