Products
InformationChargemaster Toolkit UB-04 Revenue Codes
| Revenue Code | Short Description | Long Description |
|---|---|---|
| 0001 | Total Charge | Total Charge |
| 0022 | SNF PPS Claim - TOB 21X | Health Insurance Prospective Payment System (HIPPS) - Skilled Nursing Facility |
| 0023 | HH PPS Claim - TOB 32X & 33X | Health Insurance Prospective Payment System (HIPPS) - Home Health |
| 0024 | IP Rehab PPS | Health Insurance Prospective Payment System (HIPPS) - Inpatient Rehabilitation Facility |
| 0100 | R&B - All Inclusive - Plus Ancillary | All Inclusive Rate - Room and Board Plus Ancillary |
| 0101 | R&B - All Inclusive | All Inclusive Rate - Room and Board |
| 0110 | R&B - Private - Gen | Room & Board - Private (One Bed) - General Classification |
| 0111 | R&B - Private - Med/Surg/GYN | Room & Board - Private (One Bed) - Medical/Surgical/GYN |
| 0112 | R&B - Private - OB | Room & Board - Private (One Bed) - Obstetrics (OB) |
| 0113 | R&B - Private - Pedi | Room & Board - Private (One Bed) - Pediatric |
| 0114 | R&B - Private - Psych | Room & Board - Private (One Bed) - Psychiatric |
| 0115 | R&B - Private - Hospice | Room & Board - Private (One Bed) - Hospice |
| 0116 | R&B - Private - Detox | Room & Board - Private (One Bed) - Detoxification |
| 0117 | R&B - Private - Oncology | Room & Board - Private (One Bed) - Oncology |
| 0118 | R&B - Private - Rehab | Room & Board - Private (One Bed) - Rehabilitation |
| 0119 | R&B - Private - Other | Room & Board - Private (One Bed) - Other |
| 0120 | R&B - Semiprivate - General | Room & Board - Semi-private (Two Beds) - General Classification |
| 0121 | R&B - Semiprivate - Med/Surg/Gyn | Room & Board - Semi-private (Two Beds) - Medical/Surgical/GYN |
| 0122 | R&B - Semiprivate - OB | Room & Board - Semi-private (Two Beds) - Obstetrics (OB) |
| 0123 | R&B - Semiprivate - Pedi | Room & Board - Semi-private (Two Beds) - Pediatric |
| 0124 | R&B - Semiprivate - Psych | Room & Board - Semi-private (Two Beds) - Psychiatric |
| 0125 | R&B - Semiprivate - Hospice | Room & Board - Semi-private (Two Beds) - Hospice |
| 0126 | R&B - Semiprivate - Detox | Room & Board - Semi-private (Two Beds) - Detoxification |
| 0127 | R&B - Semiprivate - Oncology | Room & Board - Semi-private (Two Beds) - Oncology |
| 0128 | R&B - Semiprivate - Rehab | Room & Board - Semi-private (Two Beds) - Rehabilitation |
| 0129 | R&B - Semiprivate - Other | Room & Board - Semi-private (Two Beds) - Other |
| 0130 | R&B - Semiprivate, 3 & 4 beds - Gen | Room & Board - Three and Four Beds - General Classification |
| 0131 | R&B - SP_MS/Surg/GYN/ 3&4 beds | Room & Board - Three and Four Beds - Medical/Surgical/GYN |
| 0132 | R&B - SP_OB/ 3 & 4 beds | Room & Board - Three and Four Beds - Obstetrics (OB) |
| 0133 | R&B - SP_Peds/ 3 & 4 beds | Room & Board - Three and Four Beds - Pediatric |
| 0134 | R&B - SP_Psych/ 3 & 4 beds | Room & Board - Three and Four Beds - Psychiatric |
| 0135 | R&B - SP_Hospice/ 3& 4 beds | Room & Board - Three and Four Beds - Hospice |
| 0136 | R&B - SP_Detox/ 3 & 4 beds | Room & Board - Three and Four Beds - Detoxification |
| 0137 | R&B - SP_Oncology/ 3 & 4 beds | Room & Board - Three and Four Beds - Oncology |
| 0138 | R&B - SP_ Rehab/ 3 & 4 beds | Room & Board - Three and Four Beds - Rehabilitation |
| 0139 | R&B - SP_Other, 3 & 4 beds | Room & Board - Three and Four Beds - Other |
| 0140 | R&B - Private/Deluxe_Gen | Room & Board - Deluxe Private - General Classification |
| 0141 | R&B - PD_MS/Surg/GYN | Room & Board - Deluxe Private - Medical/Surgical/GYN |
| 0142 | R&B - PDeluxe_OB | Room & Board - Deluxe Private - Obstetrics (OB) |
| 0143 | R&B - PD_Pedi | Room & Board - Deluxe Private - Pediatric |
| 0144 | R&B - PD_Psych | Room & Board - Deluxe Private - Psychiatric |
| 0145 | R&B - PD_Hospice | Room & Board - Deluxe Private - Hospice |
| 0146 | R&B - PD_Detox | Room & Board - Deluxe Private - Detoxification |
| 0147 | R&B - PD_Oncology | Room & Board - Deluxe Private - Oncology |
| 0148 | R&B - PD_ Rehab | Room & Board - Deluxe Private - Rehabilitation |
| 0149 | R&B - Other Private Deluxe | Room & Board - Deluxe Private - Other |
| 0150 | R&B - Ward, General | Room & Board - Ward - General Classification |
| 0151 | R&B - Med-sur-Gy/Ward | Room & Board - Ward - Medical/Surgical/GYN |
| 0152 | R&B - OB/Ward | Room & Board - Ward - Obstetrics (OB) |
| 0153 | R&B - Peds/Ward | Room & Board - Ward - Pediatrics |
| 0154 | R&B - Psych/Ward | Room & Board - Ward - Psychiatric |
| 0155 | R&B - Hospice/Ward | Room & Board - Ward - Hospice |
| 0156 | R&B - Detox/Ward | Room & Board - Ward - Detoxification |
| 0157 | R&B - Oncology/Ward | Room & Board - Ward - Oncology |
| 0158 | R&B - Rehab/Ward | Room & Board - Ward - Rehabilitation |
| 0159 | R&B - Other/Ward | Room & Board - Ward - Other |
| 0160 | R&B - Other_Gen | Room & Board - Other - General Classification |
| 0161 | ROOM & BOARD - HOSPITAL AT HOME | ROOM & BOARD - HOSPITAL AT HOME |
| 0164 | R&B - Sterile Environment | Room & Board - Other - Sterile Environment |
| 0167 | R&B - Self Care | Room & Board - Other - Self Care |
| 0169 | R&B - Other | Room & Board - Other - Other |
| 0170 | Nursery - General | Nursery - General Classification |
| 0171 | Newborn-Level I | Nursery - Newborn - Level I |
| 0172 | Newborn-Level II | Nursery - Newborn - Level II |
| 0173 | Newborn-Level III | Nursery - Newborn - Level III |
| 0174 | Newborn-Level IV | Nursery - Newborn - Level IV |
| 0179 | Nursery/Other | Nursery - Other |
| 0180 | LOA - General | Leave of Absence - General Classification |
| 0182 | LOA_Pt Convenience | Leave of Absence - Patient Convenience |
| 0183 | LOA_Therapeutic | Leave of Absence - Therapeutic Leave |
| 0185 | LOA_Hospitalization | Leave of Absence - Nursing Home (for Hospitalization) |
| 0189 | LOA_Other | Leave of Absence - Other |
| 0190 | Subacute - General | Subacute Care - General Classification |
| 0191 | Subacute/ Level I | Subacute Care - Level I |
| 0192 | Subacute/ Level II | Subacute Care - Level II |
| 0193 | Subacute/ Level III | Subacute Care - Level III |
| 0194 | Subacute/ Level IV | Subacute Care - Level IV |
| 0199 | Subacute/ Other | Subacute Care - Other |
| 0200 | ICU - General | Intensive Care Unit - General Classification |
| 0201 | ICU/ Surgical | Intensive Care Unit - Surgical |
| 0202 | ICU/ Medical | Intensive Care Unit - Medical |
| 0203 | ICU/ Peds | Intensive Care Unit - Pediatric |
| 0204 | ICU/ Psych | Intensive Care Unit - Psychiatric |
| 0206 | ICU/ Intermediate | Intensive Care Unit - Intermediate ICU |
| 0207 | ICU/ Burn Care | Intensive Care Unit - Burn Care |
| 0208 | ICU/ Trauma | Intensive Care Unit - Trauma |
| 0209 | ICU/ Other | Intensive Care Unit - Other |
| 0210 | CCU - General | Coronary Care Unit - General Classification |
| 0211 | CCU/ MI | Coronary Care Unit - Myocardial Infarction |
| 0212 | CCU/ Pulmonary | Coronary Care Unit - Pulmonary Care |
| 0213 | CCU/ Transplant | Coronary Care Unit - Heart Transplant |
| 0214 | CCU/ Intermediate | Coronary Care Unit - Intermediate CCU |
| 0219 | CCU/ Other | Coronary Care Unit - Other |
| 0220 | Special Chgs_Gen | Special Charges - General Classification |
| 0221 | Admit Chg | Special Charges - Admission Charge |
| 0222 | Tech Suppt Chg | Special Charges - Technical Support Charge |
| 0223 | UR Chg | Special Charges - U.R. Service Charge |
| 0224 | Late DC/Med Nec | Special Charges - Late Discharge, Medically Necessary |
| 0229 | Othr Spec Chg | Special Charges - Other |
| 0230 | Nursing Increm/ Gen | Incremental Nursing Charge - General Classification |
| 0231 | Nurs Incr/Nursery | Incremental Nursing Charge - Nursery |
| 0232 | Nurs Incr/OB | Incremental Nursing Charge - OB |
| 0233 | Nurs Incr/ ICU | Incremental Nursing Charge - ICU |
| 0234 | Nurs Incr/ CCU | Incremental Nursing Charge - CCU |
| 0235 | Nurs Incr/ Hospice | Incremental Nursing Charge - Hospice |
| 0239 | Nur Incr/ Other | Incremental Nursing Charge - Other |
| 0240 | All Incl Ancillary | All Inclusive Ancillary - General Classification |
| 0241 | InclAncillary_Basic | All Inclusive Ancillary - Basic |
| 0242 | Incl Ancillary_Compreh | All Inclusive Ancillary - Comprehensive |
| 0243 | Incl Ancillary_Specialty | All Inclusive Ancillary - Specialty |
| 0249 | All Incl Ancillary/ Other | All Inclusive Ancillary - Other |
| 0250 | Drugs_Gen | Pharmacy - General Classification |
| 0251 | Drugs_ Generic | Pharmacy - Generic Drugs |
| 0252 | Drugs_Nongeneric | Pharmacy - Non-generic Drugs |
| 0253 | Drugs/Take Home | Pharmacy - Take Home Drugs |
| 0254 | Drugs/ Incid to Dx | Pharmacy - Drugs Incident To Other Diagnostic Services |
| 0255 | Drugs/ Incident Rad | Pharmacy - Drugs Incident To Radiology |
| 0256 | Drugs/ Experim | Pharmacy - Experimental Drugs |
| 0257 | Drugs/ Nonscript | Pharmacy - Nonprescription |
| 0258 | IV Solution | Pharmacy - IV Solutions |
| 0259 | Drugs - Other | Pharmacy - Other |
| 0260 | IV Tx_Gen | IV Therapy - General Classification |
| 0261 | IV Tx_ Infsn Pump | IV Therapy - Infusion Pump |
| 0262 | IV Tx_Pharm | IV Therapy/Pharmacy Services |
| 0263 | IV Tx_Drug Deliv | IV Therapy/Drug/Supply Delivery |
| 0264 | IV Tx_Supplies | IV Therapy/Supplies |
| 0269 | IV Tx_Other | IV Therapy - Other |
| 0270 | Med-Surg Supplies/Gen | Medical/Surgical Supplies and Devices - General Classification |
| 0271 | Non-Sterile Supply | Medical/Surgical Supplies and Devices - Non-sterile Supply |
| 0272 | Sterile Supply | Medical/Surgical Supplies and Devices - Sterile Supply |
| 0273 | Take Home Supply | Medical/Surgical Supplies and Devices - Take Home Supplies |
| 0274 | Prosthetics_Orthotics | Medical/Surgical Supplies and Devices - Prosthetic/Orthotic Devices |
| 0275 | Pacemaker | Medical/Surgical Supplies and Devices - Pacemaker |
| 0276 | IOL | Medical/Surgical Supplies and Devices - Intraocular Lens |
| 0277 | O2_Take Home | Medical/Surgical Supplies and Devices - Oxygen - Take Home |
| 0278 | Supply_Implants | Medical/Surgical Supplies and Devices - Other Implants |
| 0279 | Supply_Other | Medical/Surgical Supplies and Devices - Other |
| 0280 | Oncology_Gen | Oncology - General Classification |
| 0289 | Oncology_Other | Oncology - Other |
| 0290 | DME_Gen | Durable Medical Equipment (other than renal) - General Classification |
| 0291 | DME_Rental | Durable Medical Equipment (other than renal) - Rental |
| 0292 | DME_New Purchase | Durable Medical Equipment (other than renal) - Purchase of new DME |
| 0293 | DME_Used Purchase | Durable Medical Equipment (other than renal) - Purchase of used DME |
| 0294 | DME_Supplies/Drugs | Durable Medical Equipment (other than renal) - Supplies/Drugs for DME |
| 0299 | DME_Other | Durable Medical Equipment (other than renal) - Other |
| 0300 | Lab - General | Laboratory - General Classification |
| 0301 | Lab - Chemistry | Laboratory - Chemistry |
| 0302 | Lab - Immunology | Laboratory - Immunology |
| 0303 | Lab - Home Rental | Laboratory - Renal Patient (Home) |
| 0304 | Lab - NR Dialysis | Laboratory - Non-routine Dialysis |
| 0305 | Lab - Hematology | Laboratory - Hematology |
| 0306 | Lab - Bact- Micro | Laboratory - Bacteriology & Microbiology |
| 0307 | Lab - Urology | Laboratory - Urology |
| 0309 | Lab - Other | Laboratory - Other |
| 0310 | Lab Path - General | Laboratory Pathology - General Classification |
| 0311 | Lab Path - Cytology | Laboratory Pathology - Cytology |
| 0312 | Lab Path - Histology | Laboratory Pathology - Histology |
| 0314 | Lab Path - Biopsy | Laboratory Pathology - Biopsy |
| 0319 | Lab Path - Other | Laboratory Pathology - Other |
| 0320 | Rad - Dx - General | Radiology - Diagnostic - General Classification |
| 0321 | Rad - Dx - Angiocardiography | Radiology - Diagnostic - Angiocardiography |
| 0322 | Rad - Dx - Arthrography | Radiology - Diagnostic - Arthrography |
| 0323 | Rad - Dx - Arteriography | Radiology - Diagnostic - Arteriography |
| 0324 | Rad - Dx - C XR | Radiology - Diagnostic - Chest X-Ray |
| 0329 | Rad - Dx - Other | Radiology - Diagnostic - Other |
| 0330 | Rad - Therapeutic - General | Radiology - Therapeutic and/or Chemotherapy Administration - General Classification |
| 0331 | Chemo - Injected | Radiology - Therapeutic - Chemotherapy Administration - Injected |
| 0332 | Chemo - Oral | Radiology - Therapeutic - Chemotherapy Administration - Oral |
| 0333 | Radiation Therapy | Radiology - Therapeutic - Radiation Therapy |
| 0335 | Chemo - IV | Radiology - Therapeutic - Chemotherapy Administration - IV |
| 0339 | Rad - Therapeutic - Other | Radiology - Therapeutic - Other |
| 0340 | Nuclear Med - General | Nuclear Medicine - General Classification |
| 0341 | Nuclear Med - Diagnostic Procedures | Nuclear Medicine - Diagnostic Procedures |
| 0342 | Nuclear Med - Therapeutic Procedures | Nuclear Medicine - Therapeutic Procedures |
| 0343 | Diagnostic Radiopharmaceuticals | Nuclear Medicine - Diagnostic Radiopharmaceuticals |
| 0344 | Therapeutic Radiopharmaceuticals | Nuclear Medicine - Therapeutic Radiopharmaceuticals |
| 0349 | Nuclear Med - Other | Nuclear Medicine - Other |
| 0350 | CT Scan - General | CT Scan - General Classification |
| 0351 | CT Scan - Head | CT Scan - Head Scan |
| 0352 | CT Scan - Body | CT Scan - Body Scan |
| 0359 | CT Scan - Other | CT Scan - Other |
| 0360 | OR - General | Operating Room Services - General Classification |
| 0361 | OR - Minor | Operating Room Services - Minor Surgery |
| 0362 | OR - Organ Transplant, not Kidney | Operating Room Services - Organ transplant - Other Than Kidney |
| 0367 | OR - Kidney Transplant | Operating Room Services - Kidney Transplant |
| 0369 | OR - Other | Operating Room Services - Other |
| 0370 | Anesthesia - General | Anesthesia - General Classification |
| 0371 | Anesthesia - Incident to Radiology | Anesthesia - Incident to Radiology |
| 0372 | Anesthesia - Incident to Other Dx | Anesthesia - Incident to Other Diagnostic Services |
| 0374 | Anesthesia - Acupuncture | Anesthesia - Acupuncture |
| 0379 | Anesthesia - Other | Anesthesia - Other |
| 0380 | Blood - General | Blood and Blood Components - General Classification |
| 0381 | Blood - Packed Red Cells | Blood and Blood Components - Packed Red Cells |
| 0382 | Blood - Whole Blood | Blood and Blood Components - Whole Blood |
| 0383 | Blood - Plasma | Blood and Blood Components - Plasma |
| 0384 | Blood - Platelets | Blood and Blood Components - Platelets |
| 0385 | Blood - Leukocytes | Blood and Blood Components - Leukocytes |
| 0386 | Blood - Other Components | Blood and Blood Components - Other Blood Components |
| 0387 | Blood - Other Derivatives (Cryopricipitates) | Blood and Blood Components - Other Derivatives (Cryoprecipitates) |
| 0389 | Blood - Other Blood | Blood and Blood Components - Other |
| 0390 | Blood/Components - General Classification | Administration, Processing, and Storage for Blood and Blood Components - General Classification |
| 0391 | Blood Administration (e.g., Transfusion) | Administration, Processing, and Storage for Blood and Blood Components - Administration (e.g., Transfusion) |
| 0392 | Processing and Storage | Administration, Processing, and Storage for Blood and Blood Components - Processing and Storage |
| 0399 | Blood/Components - Other Processing & Storage | Administration, Processing, and Storage for Blood and Blood Components - Other Blood Handling |
| 0400 | Imaging Service - General | Other Imaging Services - General Classification |
| 0401 | Dx Mammography | Other Imaging Services - Diagnostic Mammography |
| 0402 | Ultrasound | Other Imaging Services - Ultrasound |
| 0403 | Screening Mammography | Other Imaging Services - Screening Mammography |
| 0404 | Positron Emission (PET) Scan | Other Imaging Services - Positron Emission Tomography |
| 0409 | Other Imaging | Other Imaging Services - Other |
| 0410 | Respiratory Service - General | Respiratory Services - General Classification |
| 0412 | Resp - Inhalation Service | Respiratory Services - Inhalation Services |
| 0413 | Resp - Hyperbaric O2 (HBO) Therapy | Respiratory Services - Hyperbaric Oxygen Therapy |
| 0419 | Respiratory Service - Other | Respiratory Services - Other |
| 0420 | PT - General | Physical Therapy - General Classification |
| 0421 | PT - Visit Charge | Physical Therapy - Visit Charge |
| 0422 | PT - Hourly Charge | Physical Therapy - Hourly Charge |
| 0423 | PT - Group Rate | Physical Therapy - Group Rate |
| 0424 | PT - Eval or Re-evaluation | Physical Therapy - Evaluation or Re-evaluation |
| 0429 | PT - Other | Physical Therapy - Other |
| 0430 | OT - General | Occupational Therapy - General Classification |
| 0431 | OT - Visit Charge | Occupational Therapy - Visit Charge |
| 0432 | OT - Hourly Charge | Occupational Therapy - Hourly Charge |
| 0433 | OT - Group Rate | Occupational Therapy - Group Rate |
| 0434 | OT - Eval or Re-evaluation | Occupational Therapy - Evaluation or Reevaluation |
| 0439 | OT - Other | Occupational Therapy - Other |
| 0440 | Speech Pathol - General | Speech Therapy - Language Pathology - General Classification |
| 0441 | Speech Path - Visit Charge | Speech Therapy - Language Pathology - Visit Charge |
| 0442 | Speech Path - Hourly Charge | Speech Therapy - Language Pathology - Hourly Charge |
| 0443 | Speech Path - Group Rate | Speech Therapy - Language Pathology - Group Rate |
| 0444 | Speech Path - Eval or Re-evaluation | Speech Therapy - Language Pathology - Evaluation or Reevaluation |
| 0449 | Speech Path - Other | Speech Therapy - Language Pathology - Other |
| 0450 | ER - General | Emergency Room - General Classification |
| 0451 | ER - EMTALA | Emergency Room - EMTALA Emergency Medical Screening Services |
| 0452 | ER > EMTALA | Emergency Room - Beyond EMTALA Screening |
| 0456 | ER - Urgicare | Emergency Room - Urgent Care |
| 0459 | ER - Other | Emergency Room - Other |
| 0460 | Pulmonary Function - General | Pulmonary Function - General Classification |
| 0469 | Pulmonary Function - Other | Pulmonary Function - Other |
| 0470 | Audiology - General | Audiology - General Classification |
| 0471 | Audiology - Diagnostic | Audiology - Diagnostic |
| 0472 | Audiology - Treatment | Audiology - Treatment |
| 0479 | Audiology_Other | Audiology - Other |
| 0480 | Cardiology - General | Cardiology - General Classification |
| 0481 | Cardiology - Cardiac Cath lab | Cardiology - Cardiac Cath Lab |
| 0482 | Cardiology - Stress Test | Cardiology - Stress Test |
| 0483 | Cardiology - Echocardiology | Cardiology - Echocardiology |
| 0489 | Cardiology - Other | Cardiology - Other |
| 0490 | Ambulatory Surgery - General | Ambulatory Surgical Care - General Classification |
| 0499 | Ambulatory Surgery - Other | Ambulatory Surgical Care - Other |
| 0500 | Outpatient Services - General | Outpatient Services - General Classification |
| 0509 | Outpatient Services - Other | Outpatient Services - Other |
| 0510 | Clinic - General | Clinic - General Classification |
| 0511 | Clinic - Chronic Pain Center | Clinic - Chronic Pain Center |
| 0512 | Clinic - Dental | Clinic - Dental |
| 0513 | Clinic - Psychiatric | Clinic - Psychiatric |
| 0514 | Clinic - OB-GYN | Clinic - OB-GYN |
| 0515 | Clinic - Pediatric | Clinic - Pediatric |
| 0516 | Clinic - Urgent Care | Clinic - Urgent Care |
| 0517 | Clinic - Family Practice | Clinic - Family Practice |
| 0519 | Clinic - Other | Clinic - Other |
| 0520 | Freestanding Clinic - General | Free-Standing Clinic - General Classification |
| 0521 | Freestanding Clinic - RHC/FQHC - Clinic | Free-Standing Clinic - Clinic visit by member to RHC/FQHC |
| 0522 | Freestanding Clinic - RHC/FQHC- Home | Free-Standing Clinic - Home visit by RHC/FQHC practitioner |
| 0523 | Free-Standing Clinic - Family Practice Clinic | Free-Standing Clinic - Family Practice |
| 0524 | RHC/FQHC Visit - SNF (Part A) | Free-Standing Clinic - Visit by RHC/FQHC practitioner to a member in a SNF or Skilled Swing Bed in a covered Part A stay |
| 0525 | RHC/FQHC Visit - SNF (OTHER)/NF/ICF/MR | Free-Standing Clinic - Visit by RHC/FQHC practitioner to a member in a SNF (not in a covered Part A stay) or NF or ICF MR or other residential facility |
| 0526 | Free-Standing Clinic - Urgent Care | Free-Standing Clinic - Urgent Care |
| 0527 | RHC/FQHC Visiting Nurse Service(s) - Home (HSA) | Free-Standing Clinic - RHC/FQHC Visiting Nurse Service(s) to a member's home when in a home health shortage area |
| 0528 | RHC/FQHC Visit - Other Site | Free-Standing Clinic - Visit by RHC/FQHC practitioner to other non RHC/FQHC site (e.g., scene of accident) |
| 0529 | Free-Standing Clinic - Other Freestanding | Free-Standing Clinic - Other |
| 0530 | Osteopathic - General | Osteopathic Services - General Classification |
| 0531 | Osteopathic Therapy | Osteopathic Services - Osteopathic Therapy |
| 0539 | Osteopathic - Other | Osteopathic Services - Other |
| 0540 | Ambulance - General | Ambulance - General Classification |
| 0541 | Ambulance - Supplies | Ambulance - Supplies |
| 0542 | Ambulance - Medical Transport | Ambulance - Medical Transport |
| 0543 | Ambulance - Heart Mobile | Ambulance - Heart Mobile |
| 0544 | Ambulance - Oxygen | Ambulance - Oxygen |
| 0545 | Ambulance - Air Ambulance | Ambulance - Air Ambulance |
| 0546 | Ambulance - Neonatal Services | Ambulance - Neonatal Ambulance |
| 0547 | Ambulance - Pharmacy | Ambulance - Pharmacy |
| 0548 | Ambulance - Telephone EKG Transmission | Ambulance - EKG Transmission |
| 0549 | Ambulance - Other | Ambulance - Other |
| 0550 | Skilled Nursing - General | Skilled Nursing - General Classification |
| 0551 | Skilled Nursing - Visit Charge | Skilled Nursing - Visit Charge |
| 0552 | Skilled Nursing - Hourly Charge | Skilled Nursing - Hourly Charge |
| 0559 | Skilled Nursing - Other | Skilled Nursing - Other |
| 0560 | Med Social Services - General | Home Health (HH) - Medical Social Services - General Classification |
| 0561 | Med Soc Servs/Visit | Home Health (HH) - Medical Social Services - Visit Charge |
| 0562 | Med Soc Servs/Hour | Home Health (HH) - Medical Social Services - Hourly Charge |
| 0569 | Med Soc Servs/Other | Home Health (HH) - Medical Social Services - Other |
| 0570 | Aide/Home Health | Home Health (HH) Aide - General Classification |
| 0571 | Aide/Home Hlth/Visit | Home Health (HH) Aide - Visit Charge |
| 0572 | Aide/Home Hlth/Hour | Home Health (HH) Aide - Hourly Charge |
| 0579 | Aide/Home Hlth/Other | Home Health (HH) Aide - Other |
| 0580 | HH visit - General | Home Health (HH) - Other Visits - General Classification |
| 0581 | HH Visit Chg | Home Health (HH) - Other Visits - Visit Charge |
| 0582 | HH Hourly CHG | Home Health (HH) - Other Visits - Hourly Charge |
| 0583 | HH Assessment | Home Health (HH) - Other Visits - Assessment |
| 0589 | HH Visit - Other | Home Health (HH) - Other Visits - Other |
| 0590 | HH Service Unit - Gen | Home Health (HH) Units of Service - General Classification |
| 0600 | O2/Home Health | Home Health (HH) - Oxygen - General Classification |
| 0601 | Os/Stat Equip/Suppl/Cont | Home Health (HH) - Oxygen - Stat Equip/Supply/Content |
| 0602 | O2/Stat Equip/Under 1 LPM | Home Health (HH) - Oxygen - Stat Equip/Supply<1 LPM |
| 0603 | O2/Stat Equip/Over 4 LPM | Home Health (HH) - Oxygen - Stat Equip/Supply>4 LPM |
| 0604 | O2/Portable Add-on | Home Health (HH) - Oxygen - Portable Add-on |
| 0609 | HH - Oxygen, Other | Home Health (HH) - Oxygen - Other |
| 0610 | MRT - General (Magnetic Resonance Technology) | Magnetic Resonance Technology (MRT) - General Classification |
| 0611 | MRI - Brain (including Brainstem) | Magnetic Resonance Technology (MRT) - Brain/Brainstem |
| 0612 | MRI - Spinal Cord (including Spine) | Magnetic Resonance Technology (MRT) - Spinal Cord/Spine |
| 0614 | MRI - Other (Magnetic Resonance Imaging) | Magnetic Resonance Technology (MRT) - MRI - Other |
| 0615 | MRA - Head and Neck (Magnetic Resonance Angiography) | Magnetic Resonance Technology (MRT) - MRA - Head and Neck |
| 0616 | MRA - Lower Extremities (Magnetic Resonance Angiography) | Magnetic Resonance Technology (MRT) - MRA - Lower Extremities |
| 0618 | MRA - Other (Magnetic Resonance Angiography) | Magnetic Resonance Technology (MRT) - MRA - Other |
| 0619 | MRT - Other (Magnetic Resonance Technology) | Magnetic Resonance Technology (MRT) - Other |
| 0621 | Med/Surg Supplies - Incident to Rad | Medical Surgical Supplies - Incident to Radiology |
| 0622 | Med/Surg Supplies - Incident to Other Dx | Medical Surgical Supplies - Incident to Other Diagnostic Services |
| 0623 | Med/Surg Supplies - Surgical Dressings | Medical Surgical Supplies - Surgical Dressings |
| 0624 | MS Supplies - FDA Investigational Device | Medical Surgical Supplies - FDA Investigational Devices |
| 0630 | Drugs Req Specific ID - General | Drugs requiring specific identification-general classification |
| 0631 | Drugs - Single Source Drug | Pharmacy - Single Source Drug |
| 0632 | Drugs - Multiple Source Drug | Pharmacy - Multiple Source Drug |
| 0633 | Drugs - Restrictive Prescription | Pharmacy - Restrictive Prescription |
| 0634 | Drugs - EPO <10,000 units | Pharmacy - Erythropoietin (EPO) less than 10,000 units |
| 0635 | Drugs - EPO 10,000 units or > | Pharmacy - Erythropoietin (EPO) 10,000 or more units |
| 0636 | Drugs/ Detailed Coding Required | Pharmacy - Drugs Requiring Detailed Coding |
| 0637 | Self-Administrable Drugs | Pharmacy - Self-administrable Drugs |
| 0640 | Home IV Therapy - General | Home IV Therapy Services - General Classification |
| 0641 | Home IV Tx -NR Central Line | Home IV Therapy Services - Non-routine Nursing, Central Line |
| 0642 | Home IV Site Care - Central Line | Home IV Therapy Services - IV Site Care, Central Line |
| 0643 | Home IV Start/Chg Periph Line | Home IV Therapy Services - IV Start/Care, Peripheral Line |
| 0644 | Home IV, NR Periph Line | Home IV Therapy Services - Non-routine Nursing, Peripheral Line |
| 0645 | Home IV Train - Pt/CG Central L | Home IV Therapy Services - Training, Patient/Caregiver, Central Line |
| 0646 | Home IV Train - D Pt Central L | Home IV Therapy Services - Training, Disabled Patient, Central Line |
| 0647 | Home IV Train - Pt/CG Periph L | Home IV Therapy Services - Training, Patient/Caregiver, Peripheral Line |
| 0648 | Home IV Train Disabl Pt - Periph L | Home IV Therapy Services - Training, Disabled Patient, Peripheral Line |
| 0649 | Other Home IV Therapy Svc | Home IV Therapy Services - Other |
| 0650 | Hospice - General | Hospice Services - General Classification |
| 0651 | Hospice - Routine Home Care | Hospice Services - Routine Home Care |
| 0652 | Hospice - Continuous Home Care | Hospice Services - Continuous Home Care |
| 0655 | Hospice - IP Respite | Hospice Services - Inpatient Respite Care |
| 0656 | Hospice - IP Non-Respite | Hospice Services - General Inpatient Care (non-respite) |
| 0657 | Hospice - Physician Service | Hospice Services - Physician Services |
| 0658 | Hospice - R&B - Nursing Facility | Hospice Services - Hospice Room & Board - Nursing Facility |
| 0659 | Hospice/Other | Hospice Services - Other |
| 0660 | NH Respite Care - General Class | Respite Care - General Classification |
| 0661 | NH Respite - Hourly Chg/Nursing | Respite Care - Hourly Charge/Nursing |
| 0662 | NH Respite - Aid/Hmkr/Companion Hourly Chg | Respite Care - Hourly Charge/Aide/Homemaker/Companion |
| 0663 | NH Respite Care - Daily Charge | Respite Care - Daily Respite Charge |
| 0669 | NH Respite - Other Category | Respite Care - Other |
| 0670 | OP Spec Residence/General | Outpatient Special Residence Charges - General Classification |
| 0671 | OP spec Residence/Hosp Based | Outpatient Special Residence Charges - Hospital Owned |
| 0672 | OP Spec Residence/Contracted | Outpatient Special Residence Charges - Contracted |
| 0679 | OP Spec Residence/Other | Outpatient Special Residence Charges - Other |
| 0681 | Trauma Response - Level I | Trauma Response - Level I |
| 0682 | Trauma Response - Level II | Trauma Response - Level II |
| 0683 | Trauma Response - Level III | Trauma Response - Level III |
| 0684 | Trauma Response - Level IV | Trauma Response - Level IV |
| 0689 | Trauma Response - Other | Trauma Response - Other |
| 0690 | Pre-hospice | Pre-hospice/Palliative Care Services - General Classification |
| 0691 | Pre-hospice/Visit | Pre-hospice/Palliative Care Services - Visit Charge |
| 0692 | Pre-hospice/Hour | Pre-hospice/Palliative Care Services - Hourly Charge |
| 0693 | Pre-hospice/Eval | Pre-hospice/Palliative Care Services - Evaluation |
| 0694 | Pre-hospice/Cons&Ed | Pre-hospice/Palliative Care Services - Consultation and Education |
| 0695 | Pre-hospice/IP | Pre-hospice/Palliative Care Services - Inpatient Care |
| 0696 | Pre-hospice/Physician | Pre-hospice/Palliative Care Services - Physician Services |
| 0697 | Reserved | Reserved |
| 0698 | Reserved | Reserved |
| 0699 | Pre-hospice/Other | Pre-hospice/Palliative Care Services - Other Pre-hospice/Palliative |
| 0700 | Cast Room - General | Cast Room - General Classification |
| 0710 | Recovery Room - General | Recovery Room - General Classification |
| 0720 | Labor Rm/Delivery - General | Labor Room/Delivery - General Classification |
| 0721 | Labor Rm/Delivery - Labor | Labor Room/Delivery - Labor |
| 0722 | Labor Rm/Delivery - Delivery | Labor Room/Delivery - Delivery Room |
| 0723 | Labor Rm/Delivery - Circumcision | Labor Room/Delivery - Circumcision |
| 0724 | Labor Rm/Delivery - Birthing Center | Labor Room/Delivery - Birthing center |
| 0729 | Labor Rm/Delivery - Other | Labor Room/Delivery - Other |
| 0730 | EKG/ECG - General | EKG/ECG (Electrocardiogram) - General Classification |
| 0731 | EKG/ECG - Holter Monitor | EKG/ECG (Electrocardiogram) - Holter Monitor |
| 0732 | EKG/ECG - Telemetry | EKG/ECG (Electrocardiogram) - Telemetry |
| 0739 | EKG/ECG - Other | EKG/ECG (Electrocardiogram) - Other |
| 0740 | EEG - General | EEG (Electroencephalogram) - General Classification |
| 0750 | GastroIntestinal Services - General | Gastro-Intestinal (GI) Services - General Classification |
| 0760 | Specialty Services - General Classification | Specialty Services - General Classification |
| 0761 | Treatment Room | Specialty Services - Treatment Room |
| 0762 | Observation Hours | Specialty Services - Observation Hours |
| 0769 | Other Specialty Services | Specialty Services - Other |
| 0770 | Preventive Care Services - General | Preventive Care Services - General Classification |
| 0771 | Preventive - Vaccine Administration | Preventive Care Services - Vaccine Administration |
| 0780 | Telemedicine - General | Telemedicine - General Classification |
| 0790 | ESWT- General | Extra-Corporeal Shock Wave Therapy - General Classification |
| 0800 | IP Renal Dialysis/General | Inpatient Renal Dialysis - General Classification |
| 0801 | IP Hemodialysis | Inpatient Renal Dialysis - Hemodialysis |
| 0802 | IP Peritoneal Dialysis (not CAPD) | Inpatient Renal Dialysis - Peritoneal Dialysis (Non-CAPD) |
| 0803 | IP Cont Periton Dialysis (CAPD) | Inpatient Renal Dialysis - Continuous Ambulatory Peritoneal Dialysis (CAPD) |
| 0804 | IP Cont Cycle Perit Dialysis (CCPD) | Inpatient Renal Dialysis - Continuous Cycling Peritoneal Dialysis (CCPD) |
| 0809 | IP Dialysis - Other | Inpatient Renal Dialysis - Other |
| 0810 | Organ Acq - General | Acquisition of Body Components - General Classification |
| 0811 | Organ Acq - Living Donor | Acquisition of Body Components - Living Donor |
| 0812 | Organ Acq - Cadaver Donor | Acquisition of Body Components - Cadaver Donor |
| 0813 | Organ Acq - Unknown Donor | Acquisition of Body Components - Unknown Donor |
| 0814 | Unsuccessful Search | Acquisition of Body Components - Unsuccessful Organ Search - Donor Bank Charges |
| 0815 | Stem Cell | Acquisition of Body Components - Stem Cells - Allogeneic (Effective 1/1/17) |
| 0816 | Reserved | Reserved |
| 0817 | Reserved | Reserved |
| 0819 | Organ Acq - Other Donor | Acquisition of Body Components - Other Donor |
| 0820 | Hemo/OP or Home/General Classification | Hemodialysis - Outpatient or Home - General Classification |
| 0821 | Hemo/OP or Home/Composite | Hemodialysis - Outpatient or Home - Hemodialysis Composite or Other Rate |
| 0822 | Hemo/OP or Home/Home/Suppl | Hemodialysis - Outpatient or Home - Home Supplies |
| 0823 | Hemo/OP or Home/Home/Equip | Hemodialysis - Outpatient or Home - Home Equipment |
| 0824 | Hemo/OP or Home/Home/100% | Hemodialysis - Outpatient or Home - Maintenance 100% |
| 0825 | Hemo/OP or Home/Home/SupServ | Hemodialysis - Outpatient or Home - Support Services |
| 0826 | Hemo/OP or Home/Additional | Hemodialysis - Outpatient or Home - Hemodiialysis - Additional Hemodialysis Treatments With Medical Justification (Effective TBD) |
| 0829 | Hemo/OP or Home/Other OP | Hemodialysis - Outpatient or Home - Other OP Hemodialysis |
| 0830 | OP/H Peritoneal Dialysis | Peritoneal Dialysis - Outpatient or Home - General Classification |
| 0831 | OP/H Peritoneal Dialysis - Composite | Peritoneal Dialysis - Outpatient or Home - Peritoneal/Composite or Other Rate |
| 0832 | Peritoneal Dialysis - Home Supplies | Peritoneal Dialysis - Outpatient or Home - Home Supplies |
| 0833 | Peritoneal Dialysis - Home Equipment | Peritoneal Dialysis - Outpatient or Home - Home Equipment |
| 0834 | OP/H Peritoneal Dialysis - Maintenance 100% | Peritoneal Dialysis - Outpatient or Home - Maintenance 100% |
| 0835 | OP/H Peritoneal Dialysis - Support Services | Peritoneal Dialysis - Outpatient or Home - Support Services |
| 0839 | OP/H Peritoneal Dialysis - Other | Peritoneal Dialysis - Outpatient or Home - Other |
| 0840 | OP/H CAPD - Gen | Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - General Classification |
| 0841 | OP/H CAPD - Composite/Othr Rate | Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - CAPD/Composite or Other Rate |
| 0842 | OP/H CAPD Home Supplies | Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - Home Supplies |
| 0843 | CAPD OP-Home Equipment | Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - Home Equipment |
| 0844 | CAPD OP-Maintenance/100% | Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - Maintenance 100% |
| 0845 | OP/H CCPD Support Services | Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - Support Services |
| 0849 | CAPD/Home/Other | Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - Other |
| 0850 | CCPD/OP or Home | Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - General Classification |
| 0851 | CCPD/Composite | Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - CCPD/Composite or Other Rate |
| 0852 | OP/H CCPD - Home Supplies | Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Home Supplies |
| 0853 | OP/H CCPD - Home Equipment | Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Home Equipment |
| 0854 | OP/H CCPD - Maintenance 100% | Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Maintenance 100% |
| 0855 | CCPD/Home/SuppService | Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Support Services |
| 0859 | CCPD/Home/Other | Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Other |
| 0860 | Magnetoencephalography (MEG) | Magnetoencephalography (MEG) - General Classification |
| 0861 | Magnetoencephalography (MEG) | Magnetoencephalography (MEG) - MEG |
| 0870 | Cell/Gene Therapy - General | Cell/Gene Therapy - General Classification |
| 0871 | Cell/Gene Therapy - Collection | Cell/Gene Therapy - Cell Collection |
| 0872 | Cell/Gene Therapy - Processing/Storage Prior to Transport | Cell/Gene Therapy - Specialized Biologic Processing and Storage - Prior to Transport |
| 0873 | Cell/Gene Therapy - Processing/Storage After Receipt | Cell/Gene Therapy - Storage and Processing after receipt of cells from manufacturer |
| 0874 | Cell/Gene Therapy - Infusion | Cell/Gene Therapy - Infusion of Modified Cells |
| 0875 | Cell/Gene Therapy - Injection | Cell/Gene Therapy - Injection of Modified Cells |
| 0880 | Misc Dialysis - General | Miscellaneous Dialysis - General Classification |
| 0881 | Dialysis - Ultrafiltration | Miscellaneous Dialysis - Ultrafiltration |
| 0882 | Home Dialysis Aid Visit | Miscellaneous Dialysis - Home Dialysis Aid Visit |
| 0889 | Misc Dialysis - Other | Miscellaneous Dialysis - Other |
| 0890 | Pharmacy - Reserved (Use 0250 for General Classification) | Pharmacy - Reserved (Use 0250 for General Classification) |
| 0891 | Pharmacy - Special Processed Drugs | Pharmacy - Special Processed Drugs - FDA Approved Cell Therapy |
| 0892 | Pharmacy - Special Processed Drugs | Pharmacy - Special Processed Drugs - FDA Approved Gene Therapy |
| 0893 | Pharmacy - Reserved (Extension of 025x and 063x) | Pharmacy - Reserved (Extension of 025x and 063x) |
| 0899 | Pharmacy - Reserved (Extension of 025x and 063x) | Pharmacy - Reserved (Extension of 025x and 063x) |
| 0900 | BH Tx - General | Behavior Health Treatments/Services - General Classification |
| 0901 | BH - Electroshock | Behavior Health Treatments/Services - Electroshock Treatment |
| 0902 | BH - Milieu Therapy | Behavior Health Treatments/Services - Milieu Therapy |
| 0903 | BH - Play Therapy | Behavior Health Treatments/Services - Play Therapy |
| 0904 | BH - Activity Therapy | Behavior Health Treatments/Services - Activity Therapy |
| 0905 | BH- Intnsv OP Psych | Behavior Health Treatments/Services - Intensive Outpatient Services-Psychiatric |
| 0906 | BH - Intnsv OP Chem Depend | Behavior Health Treatments/Services - Intensive Outpatient Services-Chemical Dependency |
| 0907 | BH - Community Day Tx | Behavior Health Treatments/Services - Community Behavioral Health Program (Day Treatment) |
| 0908 | BH - Reserve for Natl Use | BH - Reserve for Natl Use |
| 0909 | BH - Reserve for Natl Use | Psychiatric/psychological treatments-other |
| 0910 | BH _ Reserve for Natl Use | Psychiatric/psychological services-general classification |
| 0911 | BH - Rehab | Behavioral Health Treatment/Services - Rehabilitation |
| 0912 | BH - PH | Behavioral Health Treatment/Services - Partial Hospitalization - Less Intensive |
| 0913 | BH - PH Intensive | Behavioral Health Treatment/Services - Partial Hospitalization - Intensive |
| 0914 | BH - Individual Rx | Behavioral Health Treatment/Services - Individual Therapy |
| 0915 | BH - Group Rx | Behavioral Health Treatment/Services - Group Therapy |
| 0916 | BH - Family Rx | Behavioral Health Treatment/Services - Family Therapy |
| 0917 | BH - Bio Feedback | Behavioral Health Treatment/Services - Bio Feedback |
| 0918 | BH - Testing | Behavioral Health Treatment/Services - Testing |
| 0919 | BH - Other | Behavioral Health Treatment/Services - Other |
| 0920 | Other Dx Services - Gen | Other Diagnostic Services - General Classification |
| 0921 | Peripheral Vascular Lab | Other Diagnostic Services - Peripheral Vascular Lab |
| 0922 | Electromyogram EMG | Other Diagnostic Services - Electromyogram |
| 0923 | Pap Smear | Other Diagnostic Services - Pap Smear |
| 0924 | Allergy Test | Other Diagnostic Services - Allergy Test |
| 0925 | Pregnancy Test | Other Diagnostic Services - Pregnancy Test |
| 0929 | Other Dx Services | Other Diagnostic Services - Other Diagnostic Service |
| 0931 | Med Rehab Day Prog - 1/2 Day | Medical Rehabilitation Day Program - Half Day |
| 0932 | Med Rehab Day Progr - Full Day | Medical Rehabilitation Day Program - Full Day |
| 0940 | Othr Therapeutic Srvc - General | Other Therapeutic Services - General Classification |
| 0941 | Recreational Therapy | Other Therapeutic Services - Recreational Therapy |
| 0942 | Education/Training | Other Therapeutic Services - Education/Training |
| 0943 | Cardiac Rehab | Other Therapeutic Services - Cardiac Rehabilitation |
| 0944 | Drug Rehab | Other Therapeutic Services - Drug Rehabilitation |
| 0945 | Alcohol Rehab | Other Therapeutic Services - Alcohol Rehabilitation |
| 0946 | Cmplx Med Equipm - Routine | Other Therapeutic Services - Complex Medical Equipment - Routine |
| 0947 | Cmplx Med Equipm - Ancillary | Other Therapeutic Services - Complex Medical Equipment - Ancillary |
| 0948 | Pulmonary Rehabilitation | Other Therapeutic Services - Pulmonary Rehabilitation |
| 0949 | Othr Therapeutic Srvc | Other Therapeutic Services - Other |
| 0951 | Athletic Training | Other Therapeutic Services - Athletic Training |
| 0952 | Kinesiotherapy | Other Therapeutic Services - Kinesiotherapy |
| 0953 | Chemical Dependency (Drug and Alcohol) | Chemical Dependency (Drug and Alcohol) |
| 0960 | Pro Fees - General | Professional Fees - General Classification |
| 0961 | Pro Fee - Psychiatric | Professional Fees - Psychiatric |
| 0962 | Pro Fees - Ophthalmology | Professional Fees - Ophthalmology |
| 0963 | Pro Fees - Anesthesiologist (MD) | Professional Fees - Anesthesiologist (MD) |
| 0964 | Pro Fees - Anesthetist (CRNA) | Professional Fees - Anesthetist (CRNA) |
| 0969 | Pro Fees - Other | Professional Fees - Other Professional Fees |
| 0971 | Pro Fees - Lab | Professional Fees - Laboratory |
| 0972 | Pro Fees - Rad - Diagnostic | Professional Fees - Radiology - Diagnostic |
| 0973 | Pro Fees - Rad - Therapeutic | Professional Fees - Radiology - Therapeutic |
| 0974 | Pro Fee - Rad - Nuclear Medicine | Professional Fees - Radiology - Nuclear Medicine |
| 0975 | Pro Fees - OR | Professional Fees - Operating Room |
| 0976 | Pro Fees - Respiratory Therapy | Professional Fees - Respiratory Therapy |
| 0977 | Pro Fees - PT | Professional Fees - Physical Therapy |
| 0978 | Pro Fees - OT | Professional Fees - Occupational Therapy |
| 0979 | Pro Fee - Speech | Professional Fees - Speech Pathology |
| 0981 | Pro Fees - ER | Professional Fees - Emergency Room |
| 0982 | Pro Fees - OP Services | Professional Fees - Outpatient Services |
| 0983 | Pro Fees - Clinic | Professional Fees - Clinic |
| 0984 | Pro Fees - MSS | Professional Fees - Medical Social Services |
| 0985 | Pro Fees - EKG | Professional Fees - EKG |
| 0986 | Pro Fees - EEG | Professional Fees - EEG |
| 0987 | Pro Fees - Hospital Visit | Professional Fees - Hospital Visit |
| 0988 | Pro Fees - Consult | Professional Fees - Consultation |
| 0989 | Pro Fees - Private Duty Nurse | Professional Fees - Private Duty Nurse |
| 0990 | Pt Convenience - General | Patient Convenience Items - General Classification |
| 0991 | Cafeteria/Guest Tray | Patient Convenience Items - Cafeteria/Guest Tray |
| 0992 | Private Linen Service | Patient Convenience Items - Private Linen Service |
| 0993 | Telephone | Patient Convenience Items - Telephone/Telecom |
| 0994 | TV/Radio | Patient Convenience Items - TV/Radio |
| 0995 | Nonpt Room Rent | Patient Convenience Items - Non-patient Room Rentals |
| 0996 | Late Discharge | Patient Convenience Items - Late Discharge |
| 0997 | Admit Kit | Patient Convenience Items - Admission Kits |
| 0998 | Barber/Beauty Shop | Patient Convenience Items - Beauty Shop/Barber |
| 0999 | Pt Convenience/Other | Patient Convenience Items - Other |
| 1000 | BH - R&B | Behavioral Health Accommodations - General Classification |
| 1001 | BH - R&B Resid/Psych | Behavioral Health Accommodations - Residential - Psychiatric |
| 1002 | BH - R&B Resid/Chem | Behavioral Health Accommodations - Residential - Chemical Dependency |
| 1003 | BH - R&B/Sup Living | Behavioral Health Accommodations - Supervised Living |
| 1004 | BH - R&B Halfway House | Behavioral Health Accommodations - Halfway House |
| 1005 | BH - R&B Group Home | Behavioral Health Accommodations - Group Home |
| 1006 | BH - Outdoor/Wild | Behavioral Health Accomodations - Outdoor Wilderness Behavioral Health (Effective 7/1/17) |
| 2101 | Acupuncture | Alternative Therapy Services - Acupuncture |
| 2102 | Accupressure | Alternative Therapy Services - Acupressure |
| 2103 | Massage Therapy | Alternative Therapy Services - Massage |
| 2104 | Reflexology | Alternative Therapy Services - Reflexology |
| 2105 | Biofeedback | Alternative Therapy Services - Biofeedback |
| 2106 | Hypnosis Therapy | Alternative Therapy Services - Hypnosis |
| 2109 | Other Alternative Therapy | Alternative Therapy Services - Other |
| 3101 | Adult Day Care - Med/Social - Hrly | Adult Care - Adult Day Care, Medical and Social - Hourly |
| 3102 | Adult Day Care - Social - Hrly | Adult Care - Adult Day Care, Social - Hourly |
| 3103 | Adult Day Care - Med/Social - Daily | Adult Care - Adult Day Care, Medical and Social - Daily |
| 3104 | Adult Day Care - Social - Daily | Adult Care - Adult Day Care, Social - Daily |
| 3105 | Adult Foster Care - Daily | Adult Care - Adult Foster Care - Daily |
| 3109 | Adult Care - Other | Adult Care - Other |
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