DENTIST Dental Providers - Dentists – 27 (IND & GP) 6P Periodontist 1223P0300X Periodontics Optician / Eye and Vision Service 28 (IND & GP) 88 Optometrist 152W00000X Providers/Optometrist EARLYSTEPS Psychologist (IND & GP) Crossovers Behavioral Health & Social 29 (IN-ST) 62 only 103T00000X Service Providers/Psychologist Audiologist EARLYSTEPS (Billing (IND & GP) Independent Speech, Language and Hearing 29 (IN-ST) 64 231H00000X Service Providers/Audiologist Respiratory, Developmental, EARLYSTEPS Indiv Rehabilitative & Restorative (IND & GP) Physical Service Providers/Physical 29 (IN-ST) 65 Therapist 225100000X Therapist LTX_Prov_ Specialty_ Desc LTX_Taxonomy_Desc EARLYSTEPS Speech, Language and Hearing (IND & GP) Speech Service Providers 29 (IN-ST) 71 Therapy 235500000X Specialist/Technologist Respiratory, Developmental, EARLYSTEPS Rehabilitative & Restorative (IND & GP) Service Providers/Occupational 29 (IN-ST) 74 Therapy 225X00000X Therapist (IND & Chiropractic 30 GP) 35 Chiropractor 111N00000X Providers/Chiropractor Psychologist (LIC/MED) Crossovers Behavioral Health & Social 31 (IN-ST) 62 only 103T00000X Service Providers/Psychologist (LIC/MED) Psychologist Behavioral Health & Social 31 (IN-ST) 6A -Clinical 103T00000X Service Providers/Psychologist (LIC/MED) Behavioral Health & Social 31 (IN-ST) 6B 103T00000X Service Providers/Psychologist (LIC/MED) Psychologist Behavioral Health & Social 31 (IN-ST) 6C - School 103T00000X Service Providers/Psychologist Psychologist - (LIC/MED) Behavioral Health & Social 31 (IN-ST) 6D 103T00000X Service Providers/Psychologist Psychologist (LIC/MED) - Behavioral Health & Social 31 (IN-ST) 6E 103T00000X Service Providers/Psychologist (LIC/MED) Psychologist Behavioral Health & Social 31 (IN-ST) 6F - All Other 103T00000X Service Providers/Psychologist
27 DENTIST (IND & GP) 6P Periodontist 1223P0300X Dental Providers - Dentists – Periodontics 28 (IND & GP) 88 Optician / Optometrist 152W00000X Eye and Vision Service Providers/Optometrist 29 EARLYSTEPS (IND & GP) (IN-ST) 62 Psychologist Crossovers only 103T00000X Behavioral Health & Social Service Providers/Psychologist 29 EARLYSTEPS (IND & GP) (IN-ST) 64 Audiologist (Billing 231H00000X Speech, Language and Hearing Service Providers/Audiologist 29 EARLYSTEPS (IND & GP) (IN-ST) 65 Indiv Physical Therapist 225100000X Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Physical Therapist LTX_Prov_ Specialty_ Desc LTX_Taxonomy_Desc 29 EARLYSTEPS (IND & GP) (IN-ST) 71 Speech Therapy 235500000X Speech, Language and Hearing Service Providers Specialist/Technologist 29 EARLYSTEPS (IND & GP) (IN-ST) 74 Therapy 225X00000X Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Occupational Therapist 30 (IND & GP) 35 Chiropractor 111N00000X Chiropractic Providers/Chiropractor 31 (LIC/MED) (IN-ST) 62 Psychologist Crossovers only 103T00000X Behavioral Health & Social Service Providers/Psychologist 31 (LIC/MED) (IN-ST) 6A Psychologist -Clinical 103T00000X Behavioral Health & Social Service Providers/Psychologist 31 (LIC/MED) (IN-ST) 6B 103T00000X Behavioral Health & Social Service Providers/Psychologist 31 (LIC/MED) (IN-ST) 6C Psychologist - School 103T00000X Behavioral Health & Social Service Providers/Psychologist 31 (LIC/MED) (IN-ST) 6D Psychologist - 103T00000X Behavioral Health & Social Service Providers/Psychologist 31 (LIC/MED) (IN-ST) 6E Psychologist - 103T00000X Behavioral Health & Social Service Providers/Psychologist 31 (LIC/MED) (IN-ST) 6F Psychologist - All Other 103T00000X Behavioral Health & Social Service Providers/Psychologist Independent
PIHP_CSoC_SystemsCompanionGuide-Sept2018_V12.docx