New MA taxonomy code requirement effective Aug. 12, 2025

Effective Aug. 12, 2025, a valid taxonomy code will be required on all MA professional and institutional claims.  

This requirement applies only to MA claims. Commercial claims will continue to be accepted with or without taxonomy codes. 

Taxonomy Code Requirements: 

• Professional Claims:
  • Electronic claims
    • Loop 2000A/Segment PRV = billing provider taxonomy code
    • Loop 2310B/Segment PRV = rendering provider taxonomy code
    • Loop 2420A/Segment PRV = rendering provider taxonomy code (if different than what is submitted at the claim level)
  • Paper claims
    • Box 19 = billing provider taxonomy code along with the ZZ qualifier
    • Box 24I = ZZ qualifier 
    • Box 24J = rendering provider taxonomy code
• Institutional Claims:
  • Electronic claims
    • Loop 2000A/Segment PRV = billing provider taxonomy code
  • Paper claims
    • Field 81 = billing provider taxonomy code along with the B3 qualifier 

To ensure timely and accurate claims processing, please ensure your processes and systems are updated prior to the Aug. 12 implementation date. Claims submitted without a valid taxonomy code will be rejected.  

If you have any questions, please reach out to your Provider Relations representative. For questions specific to electronic claim submission, you may contact the ASK-EDI Help Desk by email ([email protected]) or phone (1-800-472-6481).