Primary Care Clinician Office Visit
  • 16 May 2023
  • 1 Minute to read
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Primary Care Clinician Office Visit

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Article Summary


A Clinician Office Visit encounter with a primary care provider or in which primary care services were delivered; operationally defined by the presence of one or more of the following: (1) a service provider or attending provider identified as a primary care provider or with a qualifying primary NUCC taxonomy code; or (2) a qualifying HCPCS code for preventive and/or primary care services.


Q: What are the qualifying HCPCS and NUCC provider taxonomy code code values used to identify primary care clinician office visit encounters?
A: The codes used to identify clinician office visits (of which primary care clinician office visits are a subset) can be found here: Clinician Office Visits. The values used to additionally qualify clinician office visits as primary care clinician office visits are contained in the following value sets (which can be accessed in Ursa Studio in the Metadata Manager / Value Sets screen):

NamespaceValue TypeValue Set Name

Q: Are there any other ways -- beyond the identification of a qualifying NUCC taxonomy code in a provider's primary specialty slot -- that primary care providers are identified?
A: Yes. Providers may be designated as primary care providers through other means -- e.g., by virtue of being listed as the assigned PCP for an HMO patient on their membership record. This designation is captured in the Providers object in the Is Designated Primary Care Provider field. If this field is populated with a 1, that provider will be considered a qualifying primary care provider for the purposes of this object's logic.

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