Skip to Main Content

SHPBN-2019-022 Taxonomy Requirements for Behavioral Health Claims Routing Logic

Date: 05/10/19

Taxonomy is NOT Required for Behavioral Health Claims Routing

Taxonomy is not a required component at the time of claim submission; however if a taxonomy is submitted on your claim at the time of submission, this identifier will be utilized to determine the routing of your claim.  If a taxonomy is not billed the claim will route based on the taxonomy within the provider record Sunflower has for you.

Please ensure if you are billing a taxonomy on the claim that it is accurately reflecting the accurate taxonomy code of the provider. For example:

  • Taxonomy Code 208D00000X – Allopathic/Osteopathic Physicians **Medical**
  • Taxonomy Code 251S00000X – Community Behavioral Health **Behavioral Health**

If you have questions about this bulletin or other provider resources, please contact your Provider Relations Representative or call Customer Service at 1-877-644-4623.