June 13, 2025

BCBSKS (47163) – New Medicare Advantage Taxonomy Code Requirement Effective August 12, 2025

Effective August 12, 2025, a valid taxonomy code will be required on all Medicare Advantage (MA) professional and institutional claims. Claims submitted without a valid taxonomy code will be rejected by ASK-EDI.
Taxonomy Code Requirements:
For 837P (Professional) Claims:
<ul>
<li>Loop 2000A/Segment PRV = Billing Provider Taxonomy Code</li>
<li>Loop 2310B/Segment PRV = Rendering Provider Taxonomy Code</li>
<li>Loop 2420A/Segment PRV = Rendering Provider Taxonomy Code (if different than what is submitted at the claim level)</li>
</ul>
For 837I (Institutional) Claims:
<ul>
<li>Loop 2000A/Segment PRV = Billing Provider Taxonomy Code</li>
</ul>
Rejections for missing or invalid taxonomy codes will appear on the 277CA report.
Note: This requirement applies only to Medicare Advantage claims. Commercial claims will continue to be accepted with or without taxonomy codes.
Please ensure your systems and processes are updated prior to the August 12 implementation date to avoid claim rejections.
If you have any questions, please contact the ASK-EDI Help Desk by email (<a href="mailto:[email protected]">[email protected]</a>) or phone (1-800-472-6481).