MMIS, or Maintenance Management Information System, is a mechanized claims processing and information retrieval system for Medicaid that's required by the federal government. All states are required to operate an MMIS to support Medicaid business functions and maintain information in such areas as provider enrollment; client eligibility, including third party liability; benefit package maintenance; managed care enrollment; claims processing; and prior authorization. A fiscal agent who is a private contractor to the state, normally selected through a competitive procurement process, may operate the state's MMIS source.
- The descriptions for these codes must be used:
- to search on provider types when using the Medicaid Provider Search API
- to search on organization types when using the Organization Search API
Code | Description |
---|---|
01 | Acute Hospital |
03 | Acute Rehabilitation Hospital |
04 | Chronic Rehabilitation Hospital |
05 | Chronic Hospital |
06 | Special Other Acute Hospital |
07 | Special Other Chronic Hospital |
08 | Urgent Care Center |
09 | Laboratory |
10 | Podiatry Provider |
11 | Vision Care Provider |
12 | Chiropractor |
13 | Dental Provider |
14 | Psychologist |
15 | Physical Therapist |
16 | Speech/Language Pathologist |
18 | Occupational Therapist |
19 | Audiology Provider |
20 | Physician |
21 | Nurse Anesthetist |
22 | Nurse Midwife |
23 | Nurse Practitioner |
24 | Nurse Psychotherapist |
27 | Mental Health Group Therapy Provider |
28 | Therapy Group Provider-EPSDT <21 |
34 | Clinic FQHC |
35 | Clinic, LHD |
36 | Freestanding Oncology Center |
37 | Clinic, Rural |
38 | Clinic, General |
39 | Ambulatory Surgery Center |
40 | Autism Waiver |
41 | Home Health Agency |
42 | Medical Day Care – Adults |
43 | Medical Day Care – Children |
47 | Local Health Department/ Nurse Monitors |
50 | Substance Use Disorder Program |
51 | EPSDT Therapeutic Behavioral Services |
53 | Pediatric Nursing/Home Health Aide Services Agency |
54 | IMD Residential SUD Adult |
55 | ICF Addiction |
56 | ICF – ID |
57 | Nursing Facility |
59 | Portable X-Ray |
60 | Diagnostic Services, Other |
61 | Dialysis Facility |
62 | DMS/DME Provider |
70 | HMO/PACE |
71 | Hospice Provider |
72 | HealthChoice Managed Care Organizations |
76 | Community Options Program |
80 | Physician Assistant |
81 | Case Management - Model Waiver |
85 | Dietician/Nutritionist |
86 | Brain Injury Waiver |
87 | REM Case Management Provider |
88 | Residential Treatment Center |
89 | 1915(i) Facility |
90 | DDA Services Provider |
91 | Local Education Agencies/Local Lead Agency |
92 | ORP- Ordering, Referring, Prescribing |
94 | Social Worker |
AB | ABA Services |
AC | Acupuncture |
CC | Certified Professional Counselor |
CM | Mental Health Case Management Provider |
D2 | Physician Dentist |
DP | Diabetes Prevention Program |
HG | 1915i for Children, Youth, and Families |
MC | Outpatient Mental Health Clinic |
MH | Community Based Partial Hospitalization Program |
MT | Mobile Treatment Program |
PB | Lead Risk Investigator |
PH | Pharmacist Prescriber |
PR | Psychiatric Rehab Services Facility |
RX | Pharmacy |
SE | Supported Employment |
T1 | Ambulance Company |
VC | HIV Case Management |