Type of Bill

20.3 - Type of Bill (Rev. 10521; Issued: 12-16-20; Effective: 01-01-21; Implementation: 01-04-21) The A/B MAC (A) includes provider bills in the following columns of the report: Column (1) Total - All provider bills. Column (2) Inpatient Hospital - CMS-1450s submitted by hospitals for inpatient services with the following two-digit classification codes in Form Locator 4: 1-1 (inpatient hospital); and 4-1 (Religious Nonmedical Health Care Hospital- inpatient). Column (3) Outpatient - CMS-1450s submitted by hospitals or SNFs for outpatient services with the following two-digit classification codes in Form Locator 4: 1-3 (Hospital-outpatient); 2-3 (SNF-outpatient); 4-3 (Religious Nonmedical Health Care Hospital-outpatient); 5-3 (Religious Nonmedical Health Care-SNF-outpatient); and 8-3 (Hospital-outpatient-surgical procedures-ASC). Column (4) SNF - CMS-1450s with the following two-digit classification codes in Form Locator 4; 1-8 (hospital swing-bed); 2-1 (SNF-inpatient); 2-8 (SNF- swing bed); and 5-1 (Religious Nonmedical Health Care-SNF-inpatient). Column (5) HHA - CMS-1450s submitted by HHAs, with the following two-digit classification codes in Form Locator 4: 3-2 (HHA-Part B visits and use of DME); 3-3 (HHA-Part A visits and DME); 3-4 (HHA-Other-Part B benefits). Include HH PPS Requests for Anticipated Payment (RAPs) with three-digit classification code 3-2-2 or 3-3-2 with dates of service 10/01/2000 and greater in addition to claims in this column. Column (6) Other - CMS-1450s with the following two-digit classification codes in Form Locator 4: 1-2 (hospital inpatient-Part B benefits), 1-4 (hospital-Other-Part B benefits), 2-2 (SNF-inpatient-Part B benefits), 2-4 (SNF-Other-Part B benefits), 4-2 (Religious Nonmedical Health Care-inpatient-Part B benefits), 4-4 (Religious Nonmedical Health Care-inpatient-other), 5-2 (Religious Nonmedical Health Care-SNF inpatient-Part B benefits), 5-4 (Religious Nonmedical Health Care-SNF inpatient-other), 7-1, 7-2, 7-3, 7-4, 7-5 (Clinics-provider and independent RHCs, ESRD hospital-based or independent renal dialysis facilities, FQHCs, CMHCs, ORFs, and CORFS), and 8-1 and 8-2 (Hospices) 8-7 (Opioid Treatment Facility)