Health Care Provider Taxonomy or Characteristics Code Set Question

cbuster

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I understand that the selection of a taxonomy is not contingent upon any certification or license. As
taxonomy codes have evolved and the list has expanded, is there a best practice or guiding principle in
selection? Are publications available that reference CMS crosswalk, payer claim impact and payer
contracting of narrowed networks based upon cost containment by specialty/taxonomy?
Any insight or direction is appreciated, thank you!

CMS states a provider must select the taxonomy that “most closely describes the health care provider's type/classification/specialization, and report that code or code description in the NPI application.” It further states that the code the provider selects when applying for NPI may or may not be the same as used by Medicare and payers for credentialing. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/Taxonomy.html

NUCC http://www.nucc.org/index.php/code-sets-mainmenu-41/provider-taxonomy-mainmenu-40/more-information-mainmenu-55

Any insight or direction is appreciated, thank you! Also if you can provide any source information that would be great!
 
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