Providers, care settings, the care team and place-of-service codes — the world your codes describe.
Providers: who delivers care
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A 'provider' is anyone who delivers and bills for care:
• Physicians — MD (Doctor of Medicine) or DO (Doctor of Osteopathic Medicine), in primary care or a specialty.
• Non-physician practitioners (NPPs) — nurse practitioners (NP) and physician assistants (PA); they can see patients and bill, sometimes at a reduced rate.
• Other licensed professionals — physical therapists, psychologists, dietitians, chiropractors.
• Facilities — hospitals, surgery centers, skilled nursing facilities, labs, imaging centers.
Every provider and facility has a 10-digit National Provider Identifier (NPI) that goes on every claim.