Medicare AdvantageAdministrativeHigh impact
Special Alert December 2025 - Taxonomy Requirements
Providence Health Plan·OR·Provider News
Effective date
Mar 15, 2026
We identified it
Dec 1, 2025
Summary
Effective March 15, 2026, Providence Health Plan (PHP) and Providence Health Assurance (PHA) will require taxonomy codes on all provider-submitted Medicare and Commercial claims. Claims submitted with missing or incorrect taxonomy codes will be denied. Providers must ensure their taxonomy codes are registered with CMS and included in all claim submissions.
Action Required
By March 15, 2026: Billing team must ensure all providers have registered taxonomy codes with CMS (via https://www.cms.gov/Taxonomy). Update billing software to require and validate taxonomy codes on all claims submitted to PHP and PHA. Verify current taxonomy codes are accurate and reflect provider specialties. Configure system to reject or flag claims with missing or incorrect taxonomy codes before submission. Train billing staff on taxonomy code requirements. Update provider encounter forms and submission procedures to mandate taxonomy code entry. Failure to include correct taxonomy codes will result in claim denials.