Medicare AdvantageAdministrativeHigh impact
Special Alert December 2025 - Taxonomy Requirements
Providence Health Plan·OR·Provider News
Effective date
Mar 15, 2026
We identified it
Oct 6, 2026
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 incorrect or missing taxonomy codes will be denied. Providers must ensure their taxonomy codes are accurately registered and included in all claim submissions.
Action Required
Previously due March 15, 2026 (date passed; verify current applicability): Billing team must verify that all providers have current, accurate taxonomy codes registered with CMS (available at https://www.cms.gov). Update billing system configuration to require taxonomy codes on all claims submitted to PHP and PHA for Medicare and Commercial plans. Verify that claim submission software includes taxonomy code fields and that all provider records in the billing system contain correct taxonomy codes before the effective date. Train billing staff to validate taxonomy codes prior to claim submission. Failure to include correct taxonomy codes will result in claim denials.