Medicare AdvantageAdministrativeHigh impact
Special Alert December 2025 - Taxonomy Requirements
Providence Health Plan·OR·Provider News
Effective date
Mar 15, 2026
We identified it
Jul 2, 2026
Summary
Effective March 15, 2026, Providence Health Plan (PHP) and Providence Health Assurance (PHA) will require all providers to include taxonomy codes on every Medicare and Commercial claim submission. Claims submitted without correct or missing taxonomy codes will be denied. Providers must ensure their taxonomy code is registered with CMS and included in all claim submissions to avoid payment delays and denials.
Action Required
By March 15, 2026: Billing team must complete the following: (1) Verify and register each provider's taxonomy code through the CMS Find Your Taxonomy Code portal if not already registered; (2) Update billing software and claim submission systems to require and validate taxonomy codes on all claims to PHP and PHA before submission; (3) Configure system to automatically populate correct taxonomy codes based on provider specialty on all Medicare and Commercial claims; (4) Test billing system to ensure taxonomy codes are present on sample claims; (5) Notify all providers and clinical staff of the new requirement and provide their specific taxonomy code. Update all claim submission workflows, encounter forms, and provider documentation templates to include taxonomy code verification. Failure to include correct taxonomy codes will result in claim denials and delayed reimbursement.