Taxonomy Requirement for Ambulatory Surgery Center (ASC) Claims - Washington State Local Health Insurance - CHPW
Community Health Plan of Washington Apple Health Medicaid Plan Community Health Plan of Washington Apple Health Medicaid Plan

Taxonomy Requirement for Ambulatory Surgery Center (ASC) Claims

The Washington State Health Care Authority (HCA) has provided clarification for submitting Ambulatory Surgery Center (ASC) claims in ProviderOne (P1).

HCA requirement

  • All ASC claims are submitted as professional claims (J claim type). These claims convert in P1 to ASC facility claims (A claim type) only when an ASC taxonomy is included on the claim.
  • ASC taxonomy 261QA1903X is required. If the taxonomy is not included on the claim, then the claim will remain classified as a professional claim rather than converting to an ASC facility claim.
  • In addition, use modifier SG to indicate an ASC facility claim.

CHPW claims processing

Beginning May 2026, if ASC taxonomy 261QA1903X is not included on the claim, then the claim will be denied using message code CDTAX, “Taxonomy not appropriate for billed services per contract.

More information

Please see the HCA’s ASC billing guide for more information.

If you have any questions, please contact our Customer Service team at 1-800-440-1561.

LEARN MORE ABOUT US

[random_content group_id='25' num_posts='1']

☏ HAVE QUESTIONS ?

Sales Team

Get real answers
from real people

Phone: 1-800-440-1561
[email protected]

x
The owner of this website has made a commitment to accessibility and inclusion, please report any problems that you encounter using the contact form on this website. This site uses the WP ADA Compliance Check plugin to enhance accessibility.