Type of Bill: Field in claim UB04
Have you encountered issues with the type of bill when filling out your UB-04 claim form? Navigating the intricacies of healthcare billing can be a challenging task, and the type of bill plays a crucial role in accurately categorizing the nature of the services provided.
The "Type of Bill" (TOB) refers to a three-digit code used in the United States healthcare system, specifically in the context of medical billing. It is part of the UB-04 (CMS-1450) claim form, which is used by healthcare facilities or hospitals to bill for services provided to patients.
The type of bill code categorizes the specific type of facility, accommodation, or service provided during a patient's stay in a hospital or healthcare facility. Each code has a unique meaning and helps to identify the nature of the patient's care.
First Digit = Type of facility
Second Digit = Type of care or classification
Third Digit = Sequence of this bill in this episode of care. Referred to as a "frequency" or “definition”
First digit:
| Digit | Description |
|---|---|
| 1 | Hospital |
| 2 | Skilled Nursing Facility (SNF) |
| 3 | Home Health |
| 4 | Religious Nonmedical (Hospital) |
| 5 | Religious Nonmedical (Extended Care) - discontinued 10/01/2005 |
| 6 | Intermediate Care |
| 7 | Clinic or Hospital Based End Stage Renal Disease (ESRD) Facility |
| 8 | Special facility or hospital (Critical Access Hospital (CAH)) (Ambulatory Surgical Center (ASC)) |
| 9 | Reserved for National Assignment |
Second digit:
| Digit | Description |
|---|---|
1 |
Except Clinics & Special Facilities - Inpatient Part A |
| Clinics Only - Rural Health Center (RHC) | |
| Special Facilities Only - Hospice (non-hospital based) | |
2 |
Except Clinics & Special Facilities - Inpatient Part B (includes Home Health Agency (HHA) visits under a Part B plan of treatment |
| Clinics Only - Hospital based or Independent Renal Dialysis Center | |
| Special Facilities Only - Hospice (hospital based) | |
3 |
Except Clinics & Special Facilities - Outpatient (includes HHA visits under a Part A plan of treatment and use of HHA DME under a Part A plan of treatment) |
| Clinics Only - Free-standing Provider-based Federally Qualified Health Center (FQHC) | |
| Special Facilities Only - ASC Services to Hospital Outpatients | |
4 |
Except Clinics & Special Facilities - Other Part B (includes HHA medical and other health services not under a plan of treatment, SNF diagnostic clinical laboratory services for "nonpatients", and referenced diagnostic services) |
| Clinics Only - Other Rehabilitation Facility (ORF) | |
| Special Facilities Only - Free Standing Birthing Center | |
5 |
Except Clinics & Special Facilities - Intermediate Care-Level I |
| Clinics Only - Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| Special Facilities Only - CAH | |
6 |
Except Clinics & Special Facilities - Intermediate Care-Level II |
| Clinics Only - Community Mental Health Center (CMHC) | |
| Special Facilities Only - Residential Facility (not used for Medicare) | |
7 |
Except Clinics & Special Facilities - Subacute Inpatient, Eight Swing Beds (used to indicate billing for SNF level of care in a hospital with an approved sing bed agreement) |
| Clinics Only - Reserved for National Assignment | |
| Special Facilities Only - Reserved for National Assignment | |
8 |
Except Clinics & Special Facilities - N/A |
| Clinics Only - Reserved for National Assignment | |
| Special Facilities Only - Reserved for National Assignment | |
9 |
Except Clinics & Special Facilities - Reserved for National Assignment |
| Clinics Only - Other | |
| Special Facilities Only - Other |
Third digit:
| Digit | Description |
|---|---|
| 0 | Nonpayment or Zero Claims |
| 1 | Admit through Discharge Claim |
| 2 | Interim (First Claim) |
| 3 | Interim (Continuing Claims) |
| 4 | Interim (Last Claim) |
| 5 | Late Charge Only |
| 7 | Replacement of Prior Claim -or- Corrected Claim |
| 8 | Void -or- Cancel of a Prior Claim |
| 9 | Final Claim for a Home Health PPS Episode |
