New CMS Specialty Code for Hospitalists

When they enroll in the Medicare program, physicians self-designate their Medicare physician specialty on the Medicare enrollment application (CMS-855I or CMS-855O), or in the Internet-based Provider Enrollment, Chain and Ownership System Medicare App(PECOS). CMS uses these Medicare physician specialty codes, which describe the specific/unique types of medicine that physicians (and certain other suppliers) practice, for programmatic and claims processing purposes.

Change Request (CR) 9716 announces that the Centers for Medicare & Medicaid Services (CMS) has established a new physician specialty code for Hospitalist. The new code for Hospitalist is C6.  Medicare will also recognize the new code of C6 as a valid specialty for the following edits:

  • Ordering/certifying Part B clinical laboratory and imaging, durable medical equipment (DME), and Part A home health agency (HHA) claims
  • Critical Access Hospital (CAH) Method II Attending and Rendering claims
  • Attending, operating, or other physician or non-physician practitioner listed on CAH claims

Make sure your billing staffs are aware of this physician specialty code.