305R00000X — Preferred Provider Organization

Grouping

Managed Care Organizations

Classification

Preferred Provider Organization

Specialization

None — this code IS the classification

Section

Non-Individual

Definition

A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.

NUCC’s own wording, not a paraphrase.