Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, precertification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.
Effective April 1, 2023, the Texas Medicaid & Healthcare Partnership (TMHP) will add some new taxonomy codes associated with pharmacy providers rendering specific services. In addition, the definitions of some taxonomy codes associated with allopathic and osteopathic physicians, physician assistants, and advanced practice nursing providers will be updated. The new taxonomy codes and updates apply to Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program.
New Taxonomy Codes
The following taxonomy codes will be added for pharmacy service providers:
Provider Type |
Taxonomy Code |
Pharmacist: Cardiology |
1835C0206X – A licensed pharmacist who has demonstrated specialized knowledge and skill in direct patient care to ensure safe and effective use of medications in patients with cardiovascular disease, as members of interprofessional health care teams |
Pharmacist: Compounded Sterile Preparations |
1835C0207X – A licensed pharmacist who has demonstrated specialized knowledge and skill to ensure that sterile preparations meet the clinical needs of patients, satisfying quality, safety, and environmental control requirements, regulations, and standards in all phases of preparation, storage, transportation, and administration |
Pharmacist: Emergency Medicine |
1835E0208X – A licensed pharmacist who has demonstrated specialized knowledge and skill in the care for patients at the bedside in emergency medicine settings |
Pharmacist: Infectious Diseases |
1835I0206X – A licensed pharmacist who has demonstrated specialized knowledge and skill in the use of microbiology and pharmacology to develop, implement, and monitor drug regimens that incorporate antimicrobials to optimize therapy for patients |
Pharmacist: Solid Organ Transplant |
1835S0206X – A licensed pharmacist who has demonstrated specialized knowledge and skill delivering direct patient care and the safe and effective use of medications for patients in all phases of solid organ transplantation |
Updated Taxonomy Codes
The following taxonomy code definitions have been updated:
Provider Type |
Taxonomy Code |
Allopathic & Osteopathic Physicians: Allergy & Immunology, Allergy |
207KA0200X – A physician who specializes in the diagnosis, treatment, and management of allergies |
Allopathic & Osteopathic Physicians: Allergy & Immunology |
207KI0005X – An allergy and immunology physician who specializes in clinical and laboratory immunology disease management |
Allopathic & Osteopathic Physicians: General Practice |
208D00000X – A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions |
Allopathic & Osteopathic Physicians: Neuromusculoskeletal Medicine, Sports Medicine |
204C00000X – A Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician trained to be responsible for the continuous care in the field of sports medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine and integrates each of these into the management of the individual engaged in physical exercise (sports) whether as an individual or in team participation |
Allopathic & Osteopathic Physicians: Obstetrics & Gynecology |
207VG0400X – A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions |
Allopathic & Osteopathic Physicians: Obstetrics & Gynecology |
207VX0000X – A physician who specializes in diagnosis, treatment, and management of patients with obstetric conditions |
Allopathic & Osteopathic Physicians: Transplant Surgery |
204F00000X – A surgeon who specializes in transplant surgery |
Physician Assistants & Advanced Practice Nursing Providers: Advanced Practice Midwife |
367A00000X – Advanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. Midwives also provide primary care for individuals from adolescence throughout the lifespan as well as care for the healthy newborn during the first 28 days of life Midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment. Midwifery care includes health promotion, disease prevention, risk assessment and management, and individualized wellness education and counseling |
Providers may refer to the Washington Publishing Company website for complete descriptions of the taxonomy codes.
For more information, call the TMHP Contact Center at 800-925-9126.