Type of Bill

90.4 - Type of Bill (Rev. 2971, Issued: 05-23-14, Effective: 07-01-14, Implementation, 07-07-14) To properly bill, hospitals other than CAHs assign type of bill (TOB) 13X to all bills for outpatient hospital services and TOB 14X for non-patient (referred) laboratory specimens. A non-patient is defined as a beneficiary that is neither an inpatient nor an outpatient of a hospital, but that has a specimen that is submitted for analysis to a hospital and the beneficiary is not physically present at the hospital. TOB 14X should only be billed for non-patient lab specimens, which are paid under the clinical laboratory fee schedule at the lesser of the actual charge, the fee schedule amount, or the National Limitation Amount (NLA), (including CAHs and MD Waiver hospitals). Part B deductible and coinsurance do not apply for laboratory tests payable on the laboratory fee schedule. TOB 14X should no longer be used for referred diagnostic services other than laboratory services. CAHs should bill TOB 85X for outpatient services (including outpatient labs), and TOB 14X for non-patient laboratory specimen tests.