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Hospitalist Specialty Code

Overview

The Centers for Medicare & Medicaid Services (CMS) assigned a specialty code, “C6”, for providers that identify themselves as hospitalists. This was a monumental step in that hospitalists can now differentiate and properly benchmark their performance against other specialties, such as internal medicine and family medicine. Using this specialty code presents additional opportunities to be rewarded and minimizes unnecessary penalties.  

With the efforts of the SHM Board of Directors, SHM staff and the Public Policy Committee, a formal application was submitted outlining the argument for a hospitalist specialty code.  If it were not for the persistent advocacy efforts of SHM and its members, this code would not have even been considered, let along approved.  To the knowledge of SHM leadership, hospital medicine is the first medical specialty to be granted a specialty code without also having a board certification.

C6 was implemented on April 3, 2017. 

Where to Designate

The place to designate the C6 specialty code depends on whether the provider is new to Medicare enrollment or is an existing provider:

  • Electronically: Utilizing the PECOS system, provider credentialing offices can update existing specialty codes to C6 or enroll.

Benefits to Using

In addition to its use for enrollment, the C6 code can be used as a valid specialty for the following edits:

  • Ordering/certifying Part B clinical laboratory and imaging, durable medical equipment (DME), and Part A home health agency (HHA) claims
  • Critical Access Hospital (CAH) Method II Attending and Rendering claims
  • Attending, operating, or other physician or non-physician practitioner listed on CAH claim

Ron Greeno, MD, MHM reviews how the C6 specialty code benefits hospitalists and allows them to better benchmark against other specialties. View article

This major milestone for hospital medicine demonstrates the continued growth and impact of the specialty.

Dea Robinson, FACMPE Public Policy Committee Member