Type of Bill

The Type of Bill code on Institutional claims is comprised of two separate, one-digit codes. The first digit represents the Type of Facility, while the second digit is the Bill Classification. The following table demonstrates how NYS Medicaid will process the new codes.

HIPAA Code	HIPAA Description	MMIS Code	MMIS Description
11	Hospital - Inpatient Including Medicare Part A	3	Inpatient Hospital
12	Hospital - Inpatient Medicare Part B only	3	Inpatient Hospital
13	Hospital - Outpatient	7	Outpatient Department Hospital
14	Hospital - Other (for hospital referenced diagnostic services, or home health not under a plan of treatment)	7	Outpatient Department Hospital
15	Hospital - Intermediate Care Level I	3	Inpatient Hospital
16	Hospital - Intermediate Care Level II	3	Inpatient Hospital
17	Hospital - Subacute Inpatient (Revenue Code 19X required when this type of bill is used)	3	Inpatient Hospital
18	Hospital - Swing Beds	3	Inpatient Hospital
21	Skilled Nursing - Inpatient Including Medicare Part A	5	Nursing Facility
22	Skilled Nursing - Inpatient Medicare Part B only	5	Nursing Facility
23	Skilled Nursing - Outpatient	5	Nursing Facility
24	Skilled Nursing - Other (for hospital referenced diagnostic services, or home health not under a plan of treatment)	5	Nursing Facility
25	Skilled Nursing - Intermediate Care Level I	5	Nursing Facility
26	Skilled Nursing - Intermediate Care Level II	5	Nursing Facility
27	Skilled Nursing - Subacute Inpatient (Revenue code 19X required when this type of bill is used)	5	Nursing Facility
28	Skilled Nursing - Swing Beds	5	Nursing Facility
32	Home Health - Inpatient Medicare Part B only	2	Home
33	Home Health - Outpatient	2	Home
34	Home Health - Other (for hospital referenced diagnostic services, or home health not under a plan of treatment)	2	Home
41	Religious Non-medical Health Care Institutions - Hospital Inpatient - Inpatient including Medicare Part A	9	Other
42	Religious Non-medical Health Care Institutions - Hospital Inpatient - Inpatient including Medicare Part B only	9	Other
43	Religious Non-medical Health Care Institutions - Hospital Inpatient - Outpatient	9	Other
44	Religious Non-medical Health Care Institutions - Hospital Inpatient - Other (for hospital referenced diagnostic services, or home health not under a plan of treatment)	9	Other
45	Religious Non-medical Health Care Institutions - Hospital Inpatient - Intermediate Care Level I	9	Other
46	Religious Non-medical Health Care Institutions - Hospital Inpatient - Intermediate Care Level II	9	Other
47	Religious Non-medical Health Care Institutions - Hospital Inpatient - Subacute Inpatient (Revenue Code 19X required when this type of bill is used)	9	Other
48	Religious Non-medical Health Care Institutions - Hospital Inpatient - Swing Beds	9	Other
51	Religious Non-medical Health Care Institutions - Post-hospital Extended Care Services - Inpatient including Medicare Part A	9	Other
52	Religious Non-medical Health Care Institutions - Post-hospital Extended Care Services - Inpatient Medicare Part B only	9	Other
53	Religious Non-medical Health Care Institutions - Post-hospital Extended Care Services - Outpatient	9	Other
54	Religious Non-medical Health Care Institutions - Post-hospital Extended Care Services - Other (for hospital referenced diagnostic services, or home health not under a plan of treatment)	9	Other
55	Religious Non-medical Health Care Institutions - Post-hospital Extended Care Services - Intermediate Care Level I	9	Other
56	Religious Non-medical Health Care Institutions - Post-hospital Extended Care Services - Intermediate Care Level II	9	Other
57	Religious Non-medical Health Care Institutions - Post-hospital Extended Care Services - Subacute Inpatient (Revenue Code 19X required when this type of bill is used)	9	Other
58	Religious Non-medical Health Care Institutions - Post-hospital Extended Care Services - Swing Beds	9	Other
61	Intermediate Care - Inpatient Including Medicare Part A	3	Inpatient Hospital
62	Intermediate Care - Inpatient Medicare Part B only	3	Inpatient Hospital
63	Intermediate Care - Outpatient	7	Outpatient Department Hospital
64	Intermediate Care - Other (for hospital referenced diagnostic services, or home health not under a plan of treatment)	7	Outpatient Department Hospital
65	Intermediate Care - Intermediate Care Level I	5	Nursing Facility
66	Intermediate Care - Intermediate Care Level II	5	Nursing Facility
67	Intermediate Care - Subacute Inpatient (Revenue Code 19X required when this type of bill is used)	5	Nursing Facility
68	Intermediate Care - Swing Beds	5	Nursing Facility
71	Clinic - Rural Health	6	Clinic
72	Clinic - Hospital Based or Independent Renal Dialysis Center	7	Outpatient Department Hospital
73	Clinic - Free Standing	6	Clinic
74	Clinic - Outpatient Rehabilitation Facility (ORF)	6	Clinic
75	Clinic - Comprehensive Outpatient Rehabilitation Facility (CORF)	6	Clinic
76	Clinic - Community Mental Health Center	6	Clinic
79	Clinic - Other	6	Clinic
81	Special Facility - Hospice (non-hospital based)	5	Nursing Facility
82	Special Facility - Hospice (hospital based)	5	Nursing Facility
83	Special Facility - Ambulatory Surgery Center	6	Clinic
84	Special Facility - Free Standing Birthing Center	9	Other
85	Special Facility - Critical Access Hospital	9	Other
86	Special Facility - Residential Facility	9	Other
89	Special Facility - Other	9	Other

Type of Bill Code Structure