Intellect™
UB04 FACILITY TYPE CODE
Medical billing uses three-digit codes on a claim form to describe the type of bill a provider is submitting to a payor. Each digit has a specific purpose and is required on all UB-04 claims. See also Claim Frequency Code in this documentation.
The 3-digit code includes a two-digit facility type code followed by a one-character claim frequency code. The first digit of the facility code indicates the type of facility; i.e., 1 = Hospital, 2 = Skilled Nursing Facility, etc. The second digit of the facility code indicates the bill classification; i.e., 1 = Inpatient (Medicare Part A), 2 = Inpatient (Medicare Part B), etc.
Examples of bill type codes with 'X' representing the claim frequency code:
11X Hospital Inpatient Part A
12X Hospital Inpatient Part B
Please refer to the charts below:
Valid First-Digit Facility Codes indicating Type of Facility
Valid Second-Digit Facility Codes indicating Bill Classification
Second-Digit Special Facilities Only
Valid First-Digit Facility Codes indicating Type of Facility:
|
1 |
Hospital |
|
2 |
Skilled Nursing Facility |
|
3 |
Home Health |
|
4 |
Religious Nonmedical (Hospital) |
|
5 |
Religious Nonmedical (Extended Care) (discontinued effective 10/1/2005) |
|
6 |
Intermediate Care |
|
7 |
Clinic or Hospital Based ESRD Facility (requires special 2nd digit) |
|
8 |
Special facility or hospital (CAH) (ASC) surgery (requires special 2nd digit) |
|
9 |
Reserved for national assignment |
Valid Second-Digit Facility Codes indicating Bill Classification
EXCEPT Clinics & Special Facilities:
(Select 2nd digit from list if 1st digit is NOT '7' or '8')
|
1 |
Inpatient (Medicare Part A) |
|
2 |
Inpatient (Medicare Part B) (includes Part B plan of treatment) |
|
3 |
Outpatient |
|
4 |
Other (Medicare Part B) |
|
5 |
Intermediate Care - Level I |
|
6 |
Intermediate Care - Level II |
|
7 |
Sub-Acute Inpatient |
|
8 |
Swing Beds |
|
9 |
Reserved for national assignment |
(Select one of the following if 1st digit = '7')
|
1 |
Rural Health Center (RHC) |
|
2 |
Hospital Based or Independent Renal Dialysis Center |
|
3 |
Other Rehabilitation Facility (ORF) |
|
4 |
Comprehensive Outpatient Rehabilitation Facility (CORF) |
|
5 |
Community Mental Health Center (CMHC) |
|
6 |
Free Standing/Provider-based Federally Qualified Health Center (FQHC) |
|
7 |
Reserved for national assignment |
|
8 |
Other |
Second-Digit Special Facilities Only:
(Select one of the following if 1st digit = '8')
|
1 |
Hospice (non-hospital based) |
|
2 |
Hospice (hospital based) |
|
3 |
Ambulatory Surgery Center |
|
4 |
Free Standing Birthing Center |
|
5 |
Critical Access Hospital (CAH) |
|
6 |
Reserved for national assignment |
|
7 |
Reserved for national assignment |
|
8 |
Reserved for national assignment |
|
9 |
OTHER |
Please check the current manual for any changes or revisions:
CMS: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c25.pdf (revised 1/11/2019)
Noridian: https://med.noridianmedicare.com/web/jea/topics/claim-submission/bill-types (updated August 30, 2018)
For UB-92 claim forms, see:
