Consolidated Provider Billing Information

Posted: July 1, 2025

Consolidated Provider

When a provider chooses one national provider identifier (NPI) to bill for multiple records because they have more than one location or more than one type of service, Minnesota Health Care Programs (MHCP) will consolidate all the records under a provider type (PT) 33 record. Each record will remain active and link to the PT33 record. We consider the PT33 a “shell” record, providers will not see this record in MPSE.

Consolidation can be at the organizational or the individual level. For example, an individual consolidated provider could be an occupational therapist and also a physician’s assistant under one NPI.

Taxonomy Codes (DHS uses this for billing purposes only)

The Minnesota Department of Human Services (DHS) uses taxonomy codes to identify the correct location (organization) or provider specialty (individual) for billing and payment purposes. If an NPI represents multiple records that share the same ZIP+4, the provider is required to submit taxonomy codes for each record following enrollment and MN–ITS registration.

What are Taxonomy Codes
Taxonomy codes are administrative codes set for identifying the provider type, classification, and area of specialization for health care providers. Each taxonomy code is a unique ten character alphanumeric code that enables providers to identify their specialty at the time of claim submission. Find provider taxonomy codes on the X12.org website.

If any records are limited to and share the same taxonomy code, the provider can enter a custom taxonomy code. Each record must be unique. Even if that location or provider specialty is no longer active, the provider must add a unique taxonomy code.

Taxonomy codes can be assigned at the organizational and individual provider level. Assign only one taxonomy code per enrolled record or location.

Adding Taxonomy Codes
Providers must submit taxonomy or custom taxonomy codes to MHCP through MN–ITS. Select Taxonomy/Contract code maintenance and follow the instructions. For a tutorial, you can watch our Adding Taxonomy Codes video for consolidated providers.

UMPIs for Multiple Locations or Records

If a provider has unique Minnesota provider identifiers (UMPIs) for multiple locations and chooses to obtain and use a single NPI for all of the locations or records, MHCP will consolidate these locations or records. Once consolidation is complete, the provider must contact the lead agency or case manager for each location or record to update any existing service authorizations to avoid claim denials and payment delays.

Verify Location on Service Authorizations and Prior Authorizations

Service Authorizations (SAs) and Prior Authorizations (PAs) must have the correct location or record on the SA or PA. Providers should verify the location or record on the SA or PA before billing. If the location or record is incorrect, providers must contact the authorizing agency, lead agency (a county, tribal government or managed care organization), case manager or the PA agent, to update the SA or PA with the correct location or record.

Billing

When billing through MN–ITS, you must select the record with the correct taxonomy code information (if applicable) on the Billing Provider screen. When billing via batch, you must enter the correct ZIP+4 and the taxonomy code in the “Loop: 2000A, PRV03” (if applicable).

Refer to the appropriate MN–ITS User Manual claims guide to submit your claim.

Note: If you have a unique ZIP+4 (no other location has the same ZIP+4) and you enter a taxonomy code on the claim, our claim system will not read the taxonomy code being sent. For example, you have four records with the ZIP codes 55555-1111, 55555-2222, 55555-3333 and 55555-4444 and you submit a taxonomy code on your claim. Since the ZIP+4 codes are unique for all 4 records, our system will not read the taxonomy code.

Individual consolidated providers
Individual consolidated providers who bill with a taxonomy code and the claim denies, contact the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 for assistance.