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Health Coaching to be reimbursed by insurers

In the fall of 2020, the NBHWC applied for a taxonomy code for health & wellness coaches. We recently learned this was granted and will become effective April 1, 2021. This is a significant step forward for the industry as this decision further demonstrates the importance of the role of the health & wellness coach in healthcare. We understand many of you may have questions so we developed an FAQ below.

What is a taxonomy code?
A taxonomy code is a unique 10-character code that designates your classification and specialization. To find the taxonomy code that most closely describes your provider type, classification, or specialization, use the National Uniform Claim Committee (NUCC) codeset list at https://www.nucc.org.

Is there a taxonomy code for health & wellness coaches?
Yes, the code is 71400000X. This code becomes effective April 1, 2021. You will use this code when applying for a National Provider Identifier, commonly referred to as an NPI.

Who oversees taxonomy codes?
The National Uniform Claim Committee. The National Uniform Claim Committee (NUCC) is a voluntary organization that was created to develop a standardized data set for use by the non-institutional health care community to transmit claim and encounter information to and from all third-party payers. It is chaired by the American Medical Association (AMA), with the Centers for Medicare and Medicaid Services (CMS) as a critical partner. The committee is a diverse group of health care industry stakeholders representing providers, payers, designated standards maintenance organizations, public health organizations, and vendors.

How are taxonomy codes used?
A taxonomy code is used when applying for a National Provider Identifier, commonly referred to as an NPI.

What is an NPI number?
An NPI is a unique identification number for covered health care providers, created to improve the efficiency and effectiveness of electronic transmission of health information.

Who needs an NPI number?
Any healthcare provider, healthcare clearinghouse or healthcare organization that conducts transactions or uses health records that fall under HIPAA regulations is required to obtain an NPI. This includes organizations and providers that use a medical billing company to process their claims. HIPAA requires that any individual, business or healthcare agency who transmits any patient health information in electronic form in connection with a transaction is required to have an NPI number.

Do health & wellness coaches need an NPI number?
National Board Certified Health & Wellness Coaches need an NPI number if they work for a healthcare organization or in partnership with a physician, and if they currently have the ability to bill for insurance.

The NBHWC continues to work diligently towards reimbursement for health & wellness coaching, and has made this a top priority for 2021.

San Diego – NBHWC News Update Jan. 16, 2021 – Leigh-Ann Webster, NBHWC Executive Director

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