Supplemental Digital Content 1
Bice-Boxerman Continuity of Care (COC) Index
Where:
N = total number of ambulatory visits
nj = the number of ambulatory visits to provider j
s = the number of unique providers for ambulatory visits for the particular beneficiary
Usual Provider Continuity Index
UPC=n/N
Where:
n=number of ambulatory care visits to usual provider
N=total number of ambulatory care visits
Evaluation and Management Codes
The following evaluation and management codes were used to identify ambulatory care visits in
the carrier file: 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99241,
99242, 99243, 99244, 99245, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325,
99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347,
99348, 99349, 99350, 99354, 99355, 99358, 99359, 99381, 99382, 99383, 99384, 99385, 99386,
99387, 99391, 99392, 99393, 99394, 99395, 99396, 99397, G0402, G0438, G0439, 99401,
99402, 99403, 99404, 99406, 99407, 99408, 99409, 99411, 99412, 99420, 99429.
The following revenue center codes were used to identify ambulatory care visits to federally
qualified health centers, rural health centers, and critical access hospitals: 0521, 0522, 0525.
Primary Taxonomy Codes in NPPES
If only 4 or 5 digits are listed, then any taxonomy code with those first 4 digits is assigned to that
specialty type
Generalists: Primary Care Providers Considered in this Analysis
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General practice =208D00000X
Family practice = 207Q00000X, 207QA0505X
Internal medicine = 207R00000X
Geriatric medicine = 207RG0300X, 207QG0300X
Nurse practitioner (restricted to general NP, acute care, adult health, community health,
family, gerontology, general pediatrics, primary care, women’s health, school) =
363L00000X, 363LA2100X, 363LA2200X, 363LC1500X, 363LF0000X, 363LG0600X,
363LP0200X, 363LP2300X, 363LS0200X, 363LW0102X
Preventive medicine, public health and general preventive medicine =2083P0901X
Clinical Nurse Specialist (restricted to general, adult health, community health, family
health, gerontology, holistic, pediatrics, school, women’s health, home health) =
364S00000X, 364SA2200X, 364SC1501X, 364SF0001X, 364SG0600X, 364SH1100X,
364SH0200X, 364SP0200X, 364SS0200X, 364SW0102X
Physician assistant (restricted to general and medicine) = 363A00000X, 363AM0700X
Pediatrician/Adolescent Medicine (including generalist pediatrics and adolescent
medicine providers) = 208000000X, 2080A0000X, 207QA0000X, 207RA0000X
Specialists: Medical Specialists Considered in this Analysis
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Allergy/immunology = 207K00000X, 207KA0200X, 207KI0005X, 207RA0201X,
207RI0001X
Otolaryngology = 207Y******
Cardiology/peripheral vascular disease, including cardiatric electrophysiology and
interventional cardiology = 207RC0000X, 207RC0001X, 207RI0011X
Dermatology = 207N******
Interventional Pain Management = 208VP0014X
Gastroenterology = 207RG0100X
Neurology = 2084N0400X, 2084N0402X
Obstetrics/gynecology = 207V****** , except 207VX0201X because it is captured as
gynecologist/oncologist
Ophthalmology = 207W00000X
Physical medicine and rehabilitation = 2081******
Psychiatry = 2084P0800X
Pulmonary disease = 207RP1001X
Urology = 208800000X, 2088P0231X
Nephrology = 207RN0300X
Infectious disease = 207RI0200X
Endocrinology = 207RE0101X
Rheumatology = 207RR0500X
Pain Management = 208VP0000X
Addiction medicine = 207L00000X, 207QA0401X, 207RA0401X, 2084A0401X
Hematology = 207RH0000X
Hematology/oncology = 207RH0003X
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Neuropsychiatry = 2084****** , excluding 2084P0800X, 2084N0400X, 2084N0402X
because they are captured in psychiatry and neurology
Medical oncology = 207RX0202X
Radiation oncology = 2085R0001X
Gynecologist/oncologist = 207VX0201X
Nurse practitioner specialists (including critical care, neonatal, ob/gyn, occupational
health, perinatal, psychiatric) = 363L****** , excluding the 363L codes listed in
generalists
Clinical Nurse Specialist (including all the specialties not listed in generalists) =
364S*****, excluding the 364S codes listed in generalists
Preventive medicine specialties (including aerospace medicine, medical toxicology,
occupational medicine, sports medicine, hyperbaric medicine) = 2083P*****, excluding
the 2083P codes listed in pediatric generalists
Pediatric specialists (e.g., immunology, cardiology, critical care, endocrinology, etc.) =
2080******, excluding the 2080 codes listed in generalists
Bariatric medicine = 207QB0002X, 207RB0002X
Hospice/palliative = 207QH0002X, 207RH0002X
Sports medicine, including neuromuculoskeletal medicine = 207QS0010X,
207RS0010X, 204D00000X, 204C00000X
Sleep medicine = 207QS1201X, 207RS0012X
Hepatology, incuding transplant = 207RI0008X, 207RT0003X
Phlebology = 202K00000X
Examples of Medical and Surgical Specialties not Considered in this Analysis
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Radiology, interventional and diagnostic
Anesthesiology
Anesthesiology Assistant
Pathology
General surgery
Specialty surgery
Physician Assistant, surgical
Hospitalist
Critical Care
Bariatric Medicine
Emergency Medicine
Optometry
Podiatry
Undefined physician type
Speech language pathologist
Chiropractor
Nurse Midwife
Multispecialty clinic or group practice
Prosthetist/Orthotist
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Psychologist
Audiologist
Physical therapist/occupational therapist
Dietician
Social worker
Facilities (e.g., such as lab facilities, imaging facilities) and suppliers (e.g., medical
suppliers or ambulance service providers)
Ambulatory Care Sensitive Conditions
Altered mental status/acute confusion/delirium; anemia; angina; asthma; bacterial pneumonia;
cellulitis; chronic obstructive pulmonary disease/chronic bronchitis; congestive heart failure;
constipation/fecal impaction; dehydration; acute renal failure; hypokalemia; hyponatremia;
diabetes mellitus; diarrhea/gastroenteritis; c. difficile; ear, nose, and throat infections;
hypertension; hypotension; hypoglycemia; conditions preventable with immunization; ischemic
stroke; nutritional deficiencies; perforated or bleeding ulcer; pyelonephritis; ruptured appendix;
seizures; septicemia; skin ulcers; urinary tract infection; falls/trauma; weight loss/failure to
thrive; tuberculosis; influenza
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