New Physician Specialty Codes Effective October 1, 2017

The Centers for Medicare & Medicaid Services (CMS) has added three physician specialty codes, effective October 1, 2017. The specialties are as follows:

  •  Advanced Heart Failure and Transplant Cardiology (C7)
  • Medical Toxicology (C8) and
  • Hematopoietic Cell Transplantation and Cellular Therapy (C9)

The advanced heart failure and transplant cardiology designations will have an impact on new vs. established code assignment in Cardiology practices. We need further information on specialty designations C8 and C9.

The CMS-855I and CMS-855O paper applications will be updated to reflect the new specialties in the future. In the interim, providers should select the ‘Undefined physician type’ option on the enrollment application and specify the applicable specialty in the space provided.

Existing enrolled providers who want to update their specialty to reflect one of the new specialties must submit a change of information application to their MAC. Providers may submit an enrollment application to initially enroll or update their specialty within 60 days of the implementation date of the new specialties.

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