February 17, 2022

Taxonomy codes now required for New Jersey Medicaid claims

Effective for dates of service starting Dec. 1, 2021, UnitedHealthcare Community Plan of New Jersey is enforcing the taxonomy code requirement for all Medicaid claims submissions. If the required taxonomy codes are not included in a submitted claim, the claim may be denied.

Claims that have been denied due to missing taxonomy codes will need to be resubmitted with the required codes included. More information on claims resubmission can be found at UHCprovider.com/claims.

How to submit an NPI, TIN and taxonomy on a claim
UnitedHealthcare is able to accept National Provider Identifier (NPI) numbers on the UB-04 and CMS-1500 (08-05) paper and HIPAA 837 professional and institutional claim submissions. It is important that all electronic and paper claims include the tax ID number (TIN) in addition to the NPI number. In addition, we are requiring the billing provider NUCC taxonomy code to be submitted on institutional claims. Any changes to our NPI policy will be preceded with communications to physicians, health care professionals, organizations and trading partners. Such communications will express when we will reserve the right to no longer accept HIPAA transactions which do not contain a valid NPI number in the fields specified by our HIPAA-adopted implementation guides.

Please note: We will be updating the provider manual for 2022.

Questions?
More information about the taxonomy code requirement can be found in the UnitedHealthcare Community Plan of New Jersey care provider manual > Chapter 5.

Please contact your provider advocate for answers to specific questions.

PCA-22-00166-C&S-News