Appendix D: Type of Bill

Several different references exist for Type of Bill.  Generally, definitions line up but sometimes nuances exist depending on the data source.  General data definitions exist below based on the reference links here:

https://www.findacode.com/articles/type-of-bill-table-34325.html

https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R1840A3.pdf

https://med.noridianmedicare.com/web/jea/topics/claim-submission/bill-types

https://resdac.org/sites/datadocumentation.resdac.org/files/Bill%20Type%20Code.txt


Page Contents


Understanding Bill Types

To determine Type of Bill, use the following:

1st Digit = Type of Facility

2nd Digit = Bill classification (3 different categories) facilities excluding clinics and special facilities clinics only.  Special facilities only.

3rd Digit = Frequency


1ST DIGIT

TYPE OF FACILITY

2ND DIGIT

CLASSIFICATION (IF 1ST DIGIT IS 1-6)

3RD DIGIT

FREQUENCY 

(NOT SPECIFIC TO 1ST OR 2ND DIGITS)

1

HOSPITAL

1

INPATIENT (INCLUDING MEDICARE PART A) 0NON-PAYMENT/ZERO CLAIM
2

SKILLED NURSING

2

INPATIENT (MEDICARE PART B ONLY)1ADMIT THROUGH DISCHARGE CLAIM
3

HOME HEALTH

3

OUTPATIENT 2INTERIM, FIRST CLAIM
4

RELIGIOUS NON-MEDICAL (HOSPITAL)

4

OTHER (MEDICARE PART B)3INTERIM, CONTINUING CLAIMS
5

CHRISTIAN SCIENCE (EXTENDED CARE)

5

LEVEL I INTERMEDIATE CARE 4INTERIM, LAST CLAIM
6

INTERMEDIATE CARE

6

LEVEL II INTERMEDIATE CARE 5LATE CHARGE(S) ONLY CLAIM


7LEVEL III INTERMEDIATE CARE 7REPLACEMENT OF PRIOR CLAIM OR CORRECTED CLAIM


8SWING BED 8VOID OR CANCEL OF A PRIOR CLAIM

1ST DIGIT

TYPE OF FACILITY

2ND DIGIT

CLASSIFICATION (IF 1ST DIGIT IS 7)

9FINAL CLAIM FOR A HOME HEALTH PPS EPISODE 
7

CLINIC OR RENAL DIALYSIS FACILITY

(REQUIRES SPECIAL INFORMATION IN 2ND DIGIT)

1

RURAL HEALTH CLINIC

AADMISSION/  ELECTION NOTICE FOR HOSPICE


2

HOSPITAL BASED OR INDEPENDENT

RENAL DIALYSIS FACILITY

BHOSPICE TERMINATION REVOCATION NOTICE 


3

FEDERALLY QUALIFIED HEALTH CENTER (FQHC),

FREE STANDING PROVIDER-BASED

CHOSPICE CHANGE OF PROVIDER NOTICE


4OTHER REHABILITATION FACILITY (ORF)DHOSPICE ELECTION VOID / CANCEL 


5COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)FHOSPICE CHANGE OF OWNERSHIP


6COMMUNITY MENTAL HEALTH CENTER (CMHC)GCWF INITIATED ADJUSTMENT CLAIM


7FREE-STANDING PROVIDER-BASED FEDERALLY QUALIFIED HEALTH CENTER (FQHC)HCMS INITIATED ADJUSTMENT CLAIM 


9OTHERIFI ADJUSTMENT CLAIM (OTHER THAN QIO OR PROVIDER)

1ST DIGIT

TYPE OF FACILITY

2ND DIGIT

CLASSIFICATION (IF 1ST DIGIT IS 8)

JINITIATED ADJUSTMENT CLAIM / OTHER
8

SPECIALTY FACILITY

(REQUIRES SPECIAL INFORMATION IN 2ND DIGIT)

1

HOSPICE (NON-HOSPITAL BASED)KOIG INITIATED ADJUSTMENT CLAIM


2

HOSPICE (HOSPITAL BASED)MMSP INITIATED ADJUSTMENT CLAIM


3AMBULATORY SURGICAL CENTER PQIO ADJUSTMENT CLAIM


4FREE STANDING BIRTHING CENTERQREOPENING / ADJUSTMENT


5CRITICAL ACCESS HOSPITAL



9OTHER

1ST DIGITTYPE OF FACILITY2ND DIGITCLASSIFICATION (IF 1ST DIGIT IS 9)

9RESERVED FOR NATIONAL USE6 - 8RESERVED FOR NATIONAL USE



Inpatient Hospital


ValueDescription

110

NO PAY CLAIM

111

REGULAR INPATIENT

112

FIRST PORTION: CONTINUOUS STAY INPATIENT CLAIM

113

SUBSEQUENT PORTION: CONTINUOUS STAY INPATIENT CLAIM

114

FINAL PORTION: CONTINUOUS STAY INPATIENT CLAIM

115

INPATIENT: LATE CHARGE(S) ONLY CLAIM

116

INPATIENT: ADJUSTMENT OR PRIOR CLAIM NEEDED

117

INPATIENT: REPLACEMENT OF PRIOR CLAIM

118

INPATIENT: VOID/CANCEL OF PRIOR CLAIM


Hospital inpatient (Medicare Part B only)


ValueDescription

121

HOSPITAL INPATIENT (MEDICARE PART B ONLY): ADMIT THROUGH DISCHARGE

122

HOSPITAL INPATIENT (MEDICARE PART B ONLY): INTERIM, FIRST CLAIM

123

HOSPITAL INPATIENT (MEDICARE PART B ONLY): INTERIM, CONTINUING CLAIM

124

HOSPITAL INPATIENT (MEDICARE PART B ONLY): INTERIM, FINAL CLAIM

125

HOSPITAL INPATIENT (MEDICARE PART B ONLY): LATE CHARGE(S) ONLY CLAIM

127

HOSPITAL INPATIENT (MEDICARE PART B ONLY): REPLACEMENT OF PRIOR CLAIM

128

HOSPITAL INPATIENT (MEDICARE PART B ONLY): VOID/CANCEL OF PRIOR CLAIM


Outpatient Hospital

ValueDescription

131

REGULAR OUTPATIENT

132

FIRST INTERIM: CONTINUING OUTPATIENT CLAIM

133

SUBSEQUENT INTERIM: CONTINUING OUTPATIENT CLAIM

134

FINAL INTERIM: OUTPATIENT CLAIM

135

OUTPATIENT: LATE CHARGE(S) ONLY CLAIM

136

OUTPATIENT: ADJUSTMENT OF PRIOR CLAIM

137

OUTPATIENT: REPLACEMENT OF PRIOR CLAIM

138

OUTPATIENT: VOID/CANCEL OF PRIOR CLAIMS


Outpatient Diagnostic (Non Treatment Plan)

ValueDescription

141

OUTPATIENT DIAGNOSTIC: ADMIT THROUGH DISCHARGE

142

OUTPATIENT DIAGNOSTIC: INTERIM, FIRST CLAIM

143

OUTPATIENT DIAGNOSTIC: INTERIM, CONTINUING CLAIM

144

OUTPATIENT DIAGNOSTIC: INTERIM, FINAL CLAIM

145

OUTPATIENT DIAGNOSTIC: LATE CHARGE(S) ONLY CLAIM

146

OUTPATIENT DIAGNOSTIC: ADJUSTMENT OF PRIOR CLAIM

147

OUTPATIENT DIAGNOSTIC: REPLACEMENT OF PRIOR CLAIM

148

OUTPATIENT DIAGNOSTIC: VOID/CANCEL OF PRIOR CLAIM


Hospital Swing Beds

ValueDescription

181

HOSPITAL SWING BEDS: ADMIT THROUGH DISCHARGE

182

HOSPITAL SWING BEDS: INTERIM, FIRST CLAIM

183

HOSPITAL SWING BEDS: INTERIM, CONTINUING CLAIM

184

HOSPITAL SWING BEDS: INTERIM, FINAL CLAIM

185

HOSPITAL SWING BEDS: LATE CHARGE(S) ONLY CLAIM

187

HOSPITAL SWING BEDS: REPLACEMENT OF PRIOR CLAIM

188

HOSPITAL SWING BEDS: VOID/CANCEL OF PRIOR CLAIM


Skilled Nursing

ValueDescription

211

SKILLED NURSING: ADMIT THROUGH DISCHARGE

212

SKILLED NURSING: INTERIM, FIRST CLAIM

213

SKILLED NURSING: INTERIM, CONTINUING CLAIM

214

SKILLED NURSING: FINAL CLAIM

215

SKILLED NURSING: LATE CHARGE(S) ONLY CLAIM

217

SKILLED NURSING: REPLACEMENT OF PRIOR CLAIM

218

SKILLED NURSING: VOID/CANCEL OF PRIOR CLAIM


Skilled Nursing (Medicare Part B Only)

ValueDescription

221

SKILLED NURSING (MEDICARE PART B ONLY): ADMIT THROUGH DISCHARGE

222

SKILLED NURSING (MEDICARE PART B ONLY): INTERIM, FIRST CLAIM

223

SKILLED NURSING (MEDICARE PART B ONLY): INTERIM, CONTINUING CLAIM

224

SKILLED NURSING (MEDICARE PART B ONLY): FINAL CLAIM

225

SKILLED NURSING (MEDICARE PART B ONLY): LATE CHARGE(S) ONLY CLAIM

227

SKILLED NURSING (MEDICARE PART B ONLY): REPLACEMENT OF PRIOR CLAIM

228

SKILLED NURSING (MEDICARE PART B ONLY): VOID/CANCEL OF PRIOR CLAIM


Skilled Nursing Outpatient

ValueDescription

231

SKILLED NURSING OUTPATIENT: ADMIT THROUGH DISCHARGE

232

SKILLED NURSING OUTPATIENT: INTERIM, FIRST CLAIM

233

SKILLED NURSING OUTPATIENT: INTERIM, CONTINUING CLAIM

234

SKILLED NURSING OUTPATIENT: FINAL CLAIM

235

SKILLED NURSING OUTPATIENT: LATE CHARGE(S) ONLY CLAIM

237

SKILLED NURSING OUTPATIENT: REPLACEMENT OF PRIOR CLAIM

238

SKILLED NURSING OUTPATIENT: VOID/CANCEL OF PRIOR CLAIM


Home Health Inpatient (Not under a Plan of Treatment) - Description Change

ValueDescription

321

HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT): ADMIT THROUGH DISCHARGE

322

HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT): INTERIM, FIRST CLAIM

323

HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT): INTERIM, CONTINUING CLAIM

324

HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT): INTERIM, FINAL CLAIM

325

HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT): LATE CHARGE(S) ONLY CLAIM

327

HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT): REPLACEMENT OF PRIOR CLAIM

328

HOME HEALTH INPATIENT (NOT UNDER A PLAN OF TREATMENT): VOID/CANCEL OR PRIOR CLAIM


Coordinated Home Care (Medicare A Treatment Plan including DME) - Discontinued as of October 1, 2013

ValueDescription

331

COORDINATED HOME CARE: ADMIT THROUGH DISCHARGE

332

COORDINATED HOME CARE: INTERIM, FIRST CLAIM

333

COORDINATED HOME CARE: INTERIM, CONTINUING CLAIM

334

COORDINATED HOME CARE: INTERIM, FINAL CLAIM

335

COORDINATED HOME CARE: LATE CHARGE(S) ONLY CLAIM

337

COORDINATED HOME CARE: REPLACEMENT OF PRIOR CLAIM

338

COORDINATED HOME CARE: VOID/CANCEL OF PRIOR CLAIM


Home Health Services (Not Under a Plan of Treatment) - Description Change

ValueDescription

341

HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT): ADMIT THROUGH DISCHARGE

342

HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT): INTERIM, FIRST CLAIM

343

HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT): INTERIM, CONTINUING CLAIM

344

HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT): INTERIM, FINAL CLAIM

345

HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT): LATE CHARGE(S) ONLY CLAIM

347

HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT): REPLACEMENT OF PRIOR CLAIM

348

HOME HEALTH SERVICES (NOT UNDER A PLAN OF TREATMENT): VOID/CANCEL OF PRIOR CLAIM


Religious Non-Medical Health Care Institution - Hospital Inpatient

ValueDescription

411

RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - HOSPITAL INPATIENT: ADMIT THROUGH DISCHARGE

412

RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - HOSPITAL INPATIENT: INTERIM FIRST CLAIM

413

RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - HOSPITAL INPATIENT: INTERIM, CONTINUING CLAIM

414

RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - HOSPITAL INPATIENT: INTERIM, FINAL CLAIM

415

RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - HOSPITAL INPATIENT: LATE CHARGE(S) ONLY CLAIM

417

RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - HOSPITAL INPATIENT: REPLACEMENT OF PRIOR CLAIM

418

RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS - HOSPITAL INPATIENT: VOID/CANCEL OF PRIOR CLAIM


Religious Non-Medical Health Care Institution - Outpatient Services

ValueDescription

43X

RELIGIOUS NON-MEDICAL HEALTH CARE INSTITUTIONS – OUTPATIENT SERVICES


Intermediate Care - Level I

ValueDescription

65X

INPATIENT RESPITE CARE


Intermediate Care - Level II

ValueDescription

66X

GENERAL NONRESPITE  INPATIENT CARE


Clinical Rural Health

ValueDescription

711

CLINIC RURAL HEALTH: ADMIT THROUGH DISCHARGE

712

CLINIC RURAL HEALTH: INTERIM, FIRST CLAIM

713

CLINIC RURAL HEALTH: INTERIM, CONTINUING CLAIM

714

CLINIC RURAL HEALTH: INTERIM, FINAL CLAIM

715

CLINIC RURAL HEALTH: LATE CHARGE(S) ONLY CLAIM

717

CLINIC RURAL HEALTH: REPLACEMENT OF PRIOR CLAIM


Hospital Based or Independent Renal Dialysis

ValueDescription

721

HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS: ADMIT THROUGH DISCHARGE

722

HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS: INTERIM, FIRST CLAIM

723

HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS: INTERIM, CONTINUING CLAIM

724

HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS: INTERIM, FINAL CLAIM

725

HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS: LATE CHARGE(S) ONLY CLAIM

727

HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS: REPLACEMENT OF PRIOR CLAIM

728

HOSPITAL BASED OR INDEPENDENT RENAL DIALYSIS: VOID/CANCEL OF PRIOR CLAIM


Free Standing Clinic

ValueDescription

73X

FREE STANDING CLINIC


Clinic Outpatient Rehabilitation Facility (ORF)

ValueDescription

741

CLINIC OUTPATIENT REHABILITATION FACILITY (ORF): ADMIT THROUGH DISCHARGE

742

CLINIC OUTPATIENT REHABILITATION FACILITY (ORF): INTERIM, FIRST CLAIM

743

CLINIC OUTPATIENT REHABILITATION FACILITY (ORF): INTERIM, CONTINUING CLAIM

744

CLINIC OUTPATIENT REHABILITATION FACILITY (ORF): INTERIM, FINAL CLAIM

745

CLINIC OUTPATIENT REHABILITATION FACILITY (ORF): LATE CHARGE(S) ONLY CLINIC OUTPATIENT REHABILITATION FACILITY (ORF): REPLACEMENT OF PRIOR CLAIM

747

CLINIC OUTPATIENT REHABILITATION FACILITY (ORF): REPLACEMENT OF PRIOR CLAIM

748

CLINIC OUTPATIENT REHABILITATION FACILITY (ORF): VOID/CANCEL OF PRIOR CLAIM


Clinic - Comprehensive Outpatient Rehabilitation Facility (CORF)

ValueDescription

751

CLINIC OUTPATIENT REHABILITATION FACILITY (ORF): VOID/CANCEL OF PRIOR CLAIM

752

CLINIC – COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF): INTERIM, FIRST CLAIM

753

CLINIC – COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF): INTERIM, CONTINUING CLAIM

754

CLINIC – COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF): INTERIM, FINAL CLAIM

755

CLINIC – COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF): LATE CHARGE(S) ONLY CLAIM

757

CLINIC – COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF): REPLACEMENT OF PRIOR CLAIM

758

CLINIC – COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF): VOID/CANCEL OF PRIOR CLAIM


Clinic - Community Mental Health Center

ValueDescription

76X

CLINIC – COMMUNITY MENTAL HEALTH CENTER


Clinic - Federally Qualified Health Center

ValueDescription

77X

CLINIC – FEDERALLY QUALIFIED HEALTH CENTER

777

Adjustment or replacement claim


Licensed Free Standing Emergency Medical Facility

Value Description

78X

LICENSED FREE STANDING EMERGENCY MEDICAL FACILITY


Clinic - Other

ValueDescription

79X

CLINIC - OTHER


Specialty Facility Hospice (Non-Hospital Based)

ValueDescription

811

SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED): ADMIT THROUGH DISCHARGE

812

SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED): INTERIM, FIRST CLAIM

813

SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED): INTERIM, CONTINUING CLAIM

814

SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED): INTERIM, FINAL CLAIM

815

SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED): LATE CHARGE(S) ONLY

817

SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED): REPLACEMENT OF PRIOR CLAIM

818

SPECIALTY FACILITY HOSPICE (NON-HOSPITAL BASED): VOID/CANCEL OF PRIOR CLAIM


Specialty Facility Hospice (Hospital Based)

ValueDescription

821

SPECIALTY FACILITY HOSPICE (HOSPITAL BASED): ADMIT THROUGH DISCHARGE

822

SPECIALTY FACILITY HOSPICE (HOSPITAL BASED): INTERIM, FIRST CLAIM

823

SPECIALTY FACILITY HOSPICE (HOSPITAL BASED): INTERIM, CONTINUING CLAIM

824

SPECIALTY FACILITY HOSPICE (HOSPITAL BASED): INTERIM, FINAL CLAIM

825

SPECIALTY FACILITY HOSPICE (HOSPITAL BASED): LATE CHARGE(S) ONLY

827

SPECIALTY FACILITY HOSPICE (HOSPITAL BASED): REPLACEMENT OF PRIOR CLAIM

828

SPECIALTY FACILITY HOSPICE (HOSPITAL BASED): VOID/CANCEL OF PRIOR CLAIM


Specialty Facility Ambulatory Surgery

ValueDescription

831

SPECIALTY FACILITY AMBULATORY SURGERY: ADMIT THROUGH DISCHARGE

832

SPECIALTY FACILITY AMBULATORY SURGERY: INTERIM, FIRST CLAIM

833

SPECIALTY FACILITY AMBULATORY SURGERY: INTERIM, CONTINUING CLAIM

834

SPECIALTY FACILITY AMBULATORY SURGERY: INTERIM, FINAL CLAIM

835

SPECIALTY FACILITY AMBULATORY SURGERY: LATE CHARGE(S) ONLY CLAIM

837

SPECIALTY FACILITY AMBULATORY SURGERY: REPLACEMENT OF PRIOR CLAIM

838

SPECIALTY FACILITY AMBULATORY SURGERY: VOID/CANCEL OF PRIOR CLAIM


Specialty Facility - Free Standing Birthing Center - Reclassified to Outpatient Only

ValueDescription

84X

SPECIALTY FACILITY – FREE STANDING BIRTHING CENTER


Specialty Facility - Critical Access Hospital

ValueDescription

851

SPECIALTY FACILITY – CRITICAL ACCESS HOSPITAL: ADMIT THROUGH DISCHARGE

852

SPECIALTY FACILITY – CRITICAL ACCESS HOSPITAL: INTERIM, FIRST CLAIM

853

SPECIALTY FACILITY – CRITICAL ACCESS HOSPITAL: INTERIM, CONTINUING CLAIM

854

SPECIALTY FACILITY – CRITICAL ACCESS HOSPITAL: INTERIM, FINAL CLAIM

855

SPECIALTY FACILITY – CRITICAL ACCESS HOSPITAL: LATE CHARGE(S) ONLY CLAIM

857

SPECIALTY FACILITY – CRITICAL ACCESS HOSPITAL: REPLACEMENT OF PRIOR CLAIM

838

SPECIALTY FACILITY – CRITICAL ACCESS HOSPITAL: VOID/CANCEL OF PRIOR CLAIM


Specialty Facility - Residential Facility

ValueDescription

86X

SPECIALTY FACILITY – RESIDENTIAL FACILITY


Specialty Facility - Other - Reclassified to Outpatient Only

ValueDescription

89X

SPECIALTY FACILITY – OTHER