List of Revenue Codes for Medical Billing (2023)

Revenue codes in medical billing are 4 digit numeric ids that are used in hospital bills to notify insurance companies that what type of services received by patients. These are 4 digit number always starting with “0 (Zero)”. We have updated the list of Revenue Codes for Medical Billing as per the latest information effective on 15 March 2020.

The revenue codes in medical billing provide information to the insurance company on whether the services were performed like an emergency room service, operating room service, etc.

Examples of Revenue Codes-

1)– 0450- Emergency Room Service

2)– 0290- Durable medical equipment

Revenue codes in medical billing used in hospital billing or institutional claim and used on UB-04 only.

There is a standard list of revenue codes in medical billing which is updated. Revenue Codes reflect the four-digit field and approved by the National Uniform Billing Committee, USA.

. Find your revenue code from listed below

List of Revenue Codes for Medical Billing

Revenue CodesRevenue code Description
0001Total Charges
001XPayer Code
002XHealth Insurance Prospective Payment System (HIPPS)
0022Skilled Nursing Facility (PPS)
0023Home Health (PPS)
0024Inpatient Rehabilitation Facility (IRF) PPS
010XAll Inclusive Rate
0100All inclusive room and board plus ancillary
0101All inclusive room and board
011XRoom and Board Private (01 bed)
0110General
0111Medical/Surgical/GYN
0112Obstetrics (OB)
0113Pediatric
0114Psychiatric
0115Hospice
0116Detoxification
0117Oncology
0118Rehabilitation
0119Other
012XRoom and Board Semi-private (02 beds)
0120General
0121Medical/Surgical/GYN
0122OB
0123Pediatric
0124Psychiatric
0125Hospice
0126Detoxification
0127Oncology
0128Rehabilitation
0129Other
013XRoom and Board (3 and 4 beds)
0130General
0131Medical/Surgical/GYN
0132OB
0133Pediatric
0134Psychiatric
0135Hospice
0136Detoxification
0137Oncology
0138Rehabilitation
0139Other
014XRoom and Board Deluxe Private
0140General
0141Medical/Surgical/GYN
0142OB
0143Pediatric
0144Psychiatric
0145Hospice
0146Detoxification
0147Oncology
0148Rehabilitation
0149Other
015XRoom and Board Ward
0150General
0151Medical/Surgical/GYN
0152OB
0153Pediatric
0154Psychiatric
0155Hospice
0156Detoxification
0157Oncology
0158Rehabilitation
0159Other
016XOther Room and Board
0160General
0161Hospital at home, R&B/hospital at home (effective for claims received on or after July 1, 2022)
0164Sterile
0167Self-care
0169Other
017XNursery
0170General
0171New Born Level 1
0172New Born Level 2
0173New Born Level 3
0174New Born Level 4
0179Other
018XLeave of Absence
0180General
0182Patience convenience – charges billable
0183Therapeutic leave
0185Nursing home (for hospitalization)
0189Other
019XSubacute Care
0190General
0191Level 1
0192Level 2
0193Level 3
0194Level 4
0199Other
020XIntensive Care Unit
0200General
0201Surgical
0202Medical
0203Pediatric
0204Psychiatric
0206Intermediate ICU
0207Burn Care
0208Trauma
0209Other
021XSpecial Charges
0210General
0211Admission Charge
0212Technical Support Charge
0213U.R. Service Charge
0214Late Discharge – Medically Necessary
0219Other
023XIncremental Nursing Charge
0230General
0231Nursery
0232OB
0233ICU
0234CCU
0235Hospice
0239Other
024XAll-inclusive Ancillary
0240General
0260Intravenous (IV) therapy
0261Intravenous (IV) therapy, infusion pump
0262Intravenous (IV) therapy, pharmacy services
0263Intravenous (IV) therapeutic drug, supply and delivery
0264Intravenous (IV) therapy, supplies
0269Intravenous (IV) therapy, 
027XMedical/Surgical Supplies and Devices (Also see 062X, an extension of 027X)
0270Medical/Surgical Supplies and Devices, General
0271Nonsterile
0272Sterile
0273Take-home supplies
0274Prosthetic/orthotic devices
0275Pacemaker
0276Intraocular lens
0277Take-home oxygen
0278Other implants
0279Other supplies/devices
0274Medical/surgical supplies and devices, prosthetic and orthotic 
028XOncology
0281Oncology, General
0289Oncology Other
029XDurable Medical Equipment (Other than Renal)
0290Durable medical equipment, general
0291Durable medical equipment, rental
0292Durable medical equipment, purchase of new
0294Durable medical equipment, supplies and drugs
0299Durable medical equipment, 
030XLaboratory
0300Laboratory, general classification
0301Laboratory, chemistry
0302Laboratory, immunology
0303Laboratory, renal patient 
0304Laboratory, dialysis
0305Laboratory, hematology
0306Laboratory, bacteriology and microbiology
0307Laboratory, urology
0308Reserved laboratory
0309Laboratory, 
0310Laboratory, pathology general classification
0311Laboratory pathology cytology
0312Laboratory pathology histology
0313Reserved laboratory pathology
0314Laboratory, pathology biopsy
0315Reserved laboratory, pathology
0316Reserved laboratory, pathology
0317Reserved laboratory, pathology
0318Reserved laboratory, pathology
0319Laboratory, pathology 
0320Radiology, diagnostic general classification
0321Radiology, diagnostic angiocardiology
0322Radiology, diagnostic arthrography
0323Radiology, diagnostic arteriography
0324Radiology, diagnostic chest X-ray
0325Reserved radiology, diagnostic
0326Reserved radiology, diagnostic
0327Reserved radiology, diagnostic
0328Reserved radiology, diagnostic
0329Radiology, diagnostic 
0330Radiology, therapeutic chemapy general classification
0331Radiology, therapeutic chemapy, chemapy administration – injected
0332Radiology, therapeutic chemapy, chemapy and administration – oral
0333Radiology, therapeutic chemapy, radiation therapy
0334Reserved radiology, therapeutic chemapy
0335Radiology, therapeutic chemapy, administration (intravenous (IV))
0336Reserved radiology, therapeutic chemapy
0337Reserved radiology, therapeutic chemapy
0338Reserved radiology, therapeutic chemapy
0339Radiology, therapeutic chemapy 
0340Nuclear medicine, general classification
0341Nuclear medicine, diagnostic
0342Nuclear medicine, therapeutic
0343Nuclear medicine, diagnostic radiopharmaceuticals
0344Nuclear medicine, therapeutic radiopharmaceuticals
0349Nuclear medicine, 
0350Computerized axial tomography (CAT) CT scan, general
0351Computerized axial tomography (CAT) CT scan, head scan
0352Computerized axial tomography (CAT) CT scan, body scan
0353Reserved computerized axial tomography scan (CAT)
0354Reserved computerized axial tomography scan (CAT)
0355Reserved computerized axial tomography scan (CAT) 
0356Reserved computerized axial tomography scan (CAT)
0357Reserved computerized axial tomography scan (CAT)
0358Reserved computerized axial tomography scan (CAT) 
0359Computerized axial tomography scan (CAT)
0360Operating room services, general
0361Operating room services, minor surgery
0362Operating services, organ transplant  than kidney
0363Reserved operating room services
0364Reserved operating room services
0365Reserved operating room services
0366Reserved operating room services
0367Operating room services, kidney transplant
0368Reserved operating room services
0369Operating room services
0380Blood and blood products, general
0381Blood and blood products, packed red cells
0382Blood and blood products, whole blood products
0383Blood and blood products, plasma
0384Blood and blood products, platelets
0385Blood and blood products, leukocytes
0386Blood and blood products,  components
0387Blood and blood products,  derivatives (cryoprecipitate)
0388Blood and blood products, reserved components
0389Blood and blood products, 
0390Blood administration process, storage general
0391Blood administration process, storage administration
0399Blood,  storage
0400Imaging services, general
0401Imaging services, diagnostic mammography
0402Imaging services, ultrasound
0403Imaging services, screening mammography
0404Imaging services, positron emission tomography
0405Reserved imaging services
0406Reserved imaging services
0407Reserved imaging services
0408Reserved imaging services
0409Imaging services, 
0410Respiratory services, general
0411Reserved respiratory services
0412Respiratory services, inhalation
0413Respiratory services, hyperbaric oxygen therapy
0414Reserved respiratory services
0415Reserved respiratory services
0416Reserved respiratory services
0417Reserved respiratory services
0418Reserved respiratory services
0419Respiratory services, 
0420Physical therapy, general
0421Physical therapy, visit
0422Physical therapy, hourly
0423Physical therapy, group
0424Physical therapy, evaluation or reevaluation
0425Reserved physical therapy
0426Reserved physical therapy
0427Reserved physical therapy
0428Reserved physical therapy
0429Physical therapy, 
0430Occupational therapy, general
0431Occupational therapy, visit
0432Occupational therapy, hourly
0433Occupational therapy, group
0434Occupational therapy, evaluation or reevaluation
0435Reserved occupational therapy
0436Reserved occupational therapy
0437Reserved occupational therapy
0438Reserved occupational therapy
0439Occupational therapy, 
0440Speech therapy, general
0441Speech therapy, visit
0442Speech therapy, hourly
0443Speech therapy, group
0444Speech therapy, evaluation or reevaluation
0445Reserved speech therapy
0446Reserved speech therapy
0447Reserved speech therapy
0448Reserved speech therapy
0449Speech therapy, 
0450Emergency room, general
0451Emergency room, EMTALA emergency and medical
0452Emergency room, beyond EMTALA screening
0453Reserved emergency room
0454Reserved emergency room
0455Reserved emergency room
0456Emergency room, urgent care
0457Reserved emergency room
0458Reserved emergency room
0459Emergency room, 
0460Pulmonary function, general
0461Reserved pulmonary function
0462Reserved pulmonary function
0463Reserved pulmonary function
0464Reserved pulmonary function
0465Reserved pulmonary function
0466Reserved pulmonary function
0467Reserved pulmonary function
0468Reserved pulmonary function
0469Pulmonary function, 
0470Audiology, general
0471Audiology, diagnostic
0472Audiology, treatment
0473Reserved audiology
0474Reserved audiology
0475Reserved audiology
0476Reserved audiology
0477Reserved audiology
0478Reserved audiology
0479Audiology, 
0480Cardiology, general
0481Cardiology, cardiac catheterization laboratory
0482Cardiology, stress test
0483Cardiology, echocardiology
0484Reserved cardiology
0485Reserved cardiology
0486Reserved cardiology
0487Reserved cardiology
0488Reserved cardiology
0489Cardiology, 
0490Ambulatory surgery
0499, ambulatory surgery
0500Outpatient services
0510Clinic, 
0511Clinic, chronic pain center
0512Clinic, dental
0513Clinic, psychiatric
0514Clinic, obstetrics/gynecology (OB/GYN)
0515Clinic, pediatric
0516Clinic, urgent care
0517Clinic, family practice
0518Reserved clinic
0519Clinic, 
0521Rural clinic
0526Urgent care clinic
0529Other
0530Osteopathic services, general
0531Osteopathic services, therapy
0532Reserved osteopathic services
0533Reserved osteopathic services
0534Reserved osteopathic services
0535Reserved osteopathic services
0536Reserved osteopathic services
0537Reserved osteopathic services
0538Reserved osteopathic services
0539Osteopathic services, 
0540Ambulance, general
0541Ambulance, supplies
0542Ambulance, medical transport
0543Ambulance, heart mobile
0544Ambulance, oxygen
0545Ambulance, air
0546Ambulance, neonatal services
0547Ambulance, pharmacy
0548Ambulance, electrocardiogram (EKG) transmission
0549Ambulance, 
0550Skilled nursing
0551Skilled nursing, visit
0561Home health medical, social services, general
0571Aide/home health visit
0601Home health, oxygen, general
0610Magnetic resonance technology, general
0611Magnetic resonance technology, brain/brain stem
0612Magnetic resonance technology, spinal cord/spine
0613Magnetic resonance technology reserved
0614Magnetic resonance technology,  magnetic resonance imaging (MRI)
0615Magnetic resonance technology, head and neck
0616Magnetic resonance technology, lower extremities
0617Magnetic resonance technology reserved
0618Magnetic resonance technology, 
0619Magnetic resonance technology, 
0621Medical surgical supplies incidentals, radiology
0622Medical surgical supplies incidental to  diagnostic services
0624U.S. Food and Drug Administration (FDA) investigational devices
0631Drug, single
0632Drug, multi
0634Pharmacy, extension of 025X erythropoietin (EPO) less than 10,000 units
0635Pharmacy extension of 025X erythropoietin (EPO) 10,000 or more units
0636Pharmacy 025x extension drugs requiring detailed coding
0650Hospice
0651Hospice, routine home care
0652Hospice, continuous home care
0656Hospice, general inpatient care (non-respite)
0722Labor room delivery, delivery room
0723Labor room delivery, circumcision
0724Labor room delivery birthing center
0729Labor room delivery, 
0730Electrocardiogram (EKG), electroencephalogram (EEG)
0731Electrocardiogram (EKG), electroencephalogram (EEG), Holter monitor
0732Telemetry
0739Electrocardiogram (EKG), electroencephalogram (EEG), 
0740Electroencephalogram (EEG), general
0741Reserved electroencephalogram (EEG)
0742Reserved electroencephalogram (EEG)
0743Reserved electroencephalogram (EEG)
0744Reserved electroencephalogram (EEG)
0745Reserved electroencephalogram (EEG)
0746Reserved electroencephalogram (EEG)
0747Reserved electroencephalogram (EEG)
0748Reserved electroencephalogram (EEG)
0749Reserved electroencephalogram (EEG)
0750Gastrointestinal (GI) services general
0751Reserved gastrointestinal (GI) services
0752Reserved gastrointestinal (GI) services
0753Reserved gastrointestinal (GI) services
0754Reserved gastrointestinal (GI) services
0755Reserved gastrointestinal (GI) services
0756Reserved gastrointestinal (GI) services
0757Reserved gastrointestinal (GI) services
0758Reserved gastrointestinal (GI) services
0759Reserved gastrointestinal (GI) services
0760Specialty room, general
0761Specialty room, treatment room
0769Specialty room,  rooms
0770Preventive care services, general
0771Preventive care services, vaccine administration
0772Reserved preventive care services
0773Reserved preventive care services
0774Reserved preventive care services
0775Reserved preventive care services
0776Reserved preventive care services
0777Reserved preventive care services
0778Reserved preventive care services
0779Reserved preventive care services
0780Telemedicine, general
0781Reserved telemedicine
0782Reserved telemedicine
0783Reserved telemedicine
0784Reserved telemedicine
0785Reserved telemedicine
0786Reserved telemedicine
0787Reserved telemedicine
0788Reserved telemedicine
0789Reserved telemedicine
0790Extra-corporeal shock wave therapy, general
0791Reserved extra-corporeal shock wave therapy
0792Reserved extra-corporeal shock wave therapy
0793Reserved extra-corporeal shock wave therapy
0794Reserved extra-corporeal shock wave therapy
0795Reserved extra-corporeal shock wave therapy
0796Reserved extra-corporeal shock wave therapy
0797Reserved extra-corporeal shock wave therapy
0798Reserved extra-corporeal shock wave therapy
0799Reserved extra-corporeal shock wave therapy
0811Acquisition of body components, living donor
0812Acquisition of body components, cadaver donor
0813Acquisition of body components, unknown donor
0814Acquisition of body components unsuccessful organ search, donor bank charges
0819, donor
0820Hemodialysis, outpatient or home general
0821Hemodialysis, composite or  rate
0829Hemodialysis, 
0831Peritoneal dialysis, outpatient or home composite or  rate
0851Continuous cycling peritoneal dialysis, outpatient or home composite or  rate
0880Dialysis, miscellaneous
0900Behavioral health treatment services, general
0901Behavioral health treatment services, electroshock
0902Behavioral health treatment services, milieu therapy
0903Behavioral health treatment services, play therapy
0904Behavioral health treatment services, activity Therapy
0905Behavioral health treatment services, intensive outpatient psychiatric
0906Behavioral health treatment services, intensive outpatient chemical dependency
0907Behavioral health treatment services, community behavioral health program
0908Reserved behavioral health treatment services
0909Reserved behavioral health treatment services
0910Reserved behavioral health treatment services, 090X extension
0911Behavioral health treatment services, 090X extension: rehabilitation
0912Behavioral health treatment services, 090X extension: partial hospitalization, less intensive
0913Behavioral health treatment services, 090X extension: partial hospitalization, intensive
0914Behavioral health treatment services, 090X extension: individual therapy
0915Behavioral health treatment, services 090X extension: group therapy
0916Behavioral health treatment, services 090X extension: family therapy
0917Behavioral health treatment, services 090X extension: bio feedback
0918Behavioral health treatment, services 090X extension: testing
0919Behavioral health treatment, services 090X extension: 
0920 diagnostic services, general
0921 diagnostic services, peripheral vascular laboratory
0922 diagnostic services, electromyelgram
0923 diagnostic services, pap smear
0924 diagnostic services, allergy test
0925 diagnostic services, pregnancy test
0926Reserved , diagnostic services
0927Reserved , diagnostic services
0928Reserved , diagnostic services
0929 diagnostic services, 
0940 therapeutic services, general
0941 therapeutic services, recreational therapy
0942Education, training
0943Cardiac rehabilitation
0944 therapeutic services, drug rehabilitation
0945 therapeutic services, alcohol rehabilitation
0946 therapeutic services, complex medical equipment – routine
0947 therapeutic services, complex medical equipment, ancillary
0948Pulmonary rehabilitation
0949 therapeutic services, 
0950Reserved  therapeutic services, 094X extension:
0951 therapeutic services, 094X extension: athletic training
0952 therapeutic services, 094X extension: kinesiapy
0953Reserved  therapeutic services, extension of 094X
0954Reserved  therapeutic services, extension of 094X
0955Reserved  therapeutic services, extension of 094X
0956Reserved  therapeutic services, extension of 094X
0957Reserved , therapeutic services, extension of 094X
0958Reserved , therapeutic services, extension of 094X
0959Reserved , therapeutic services, extension of 094X
0960Professional fee
0961Professional fee, psychology
0962Professional fee, eye
0963Professional fee, anesthesiologist Medical Doctor
0964Professional fee, anesthesiologist, certified registered nurse anesthetist (CRNA)
0969, professional fee
0971Professional fee, laboratory
0972Professional fee, radiology, diagnostic
0975Professional fee, operating room
0981Professional fee, emergency room
0982Professional fee, outpatient
0983Professional fee, clinic
0984Professional fee, social services
0985Professional fee, electrocardiogram (EKG)
0986Professional fee, electroencephalography (EEG)
0987Professional fee, house visit
0988Professional fee, consultation
Revenue codes list

In the ever-evolving healthcare industry landscape, maximizing revenue is a priority for providers and organizations alike. One crucial aspect of revenue optimization lies in effectively understanding and utilizing CMS revenue codes. These codes, developed by the Centers for Medicare & Medicaid Services (CMS), are pivotal in billing and reimbursement. This comprehensive guide will shed light on the significance of CMS revenue codes, how to utilize them to your advantage and address common questions surrounding their implementation. So, let’s embark on this journey to unlock the secrets of maximizing your revenue!

CMS Revenue Codes: Decoding the Fundamentals

Before delving into the intricacies of CMS revenue codes, let’s establish a solid foundation by understanding their purpose and relevance. CMS revenue codes are alphanumeric codes that categorize specific healthcare services and procedures provided to patients. They play a vital role in accurately identifying and billing various services and ensuring appropriate reimbursement from insurance providers and government payers.

CMS revenue codes list

Why Are CMS Revenue Codes Important?

CMS revenue codes serve as a standardized system to effectively capture and communicate healthcare services and associated charges. They facilitate the billing process, ensuring transparency and accurate payment reimbursement. By assigning the appropriate CMS revenue codes, healthcare providers can streamline revenue cycles, minimize claim denials, and maximize financial success.

CMS revenue codes follow a structured format that efficiently identifies and classifies healthcare services. The codes consist of three digits, followed by an optional fourth digit for greater specificity. Each CMS revenue code also corresponds to a specific service or item provided, creating a uniform language for billing and reimbursement purposes.

CMS Revenue Codes: Implementation Best Practices

Now that we have a solid understanding of CMS revenue codes let’s explore some best practices for their effective implementation. By following these guidelines, healthcare providers can optimize revenue generation and avoid common pitfalls.

  • Accurate Code Selection for Precise Billing

The key to successful revenue optimization lies in accurately selecting the appropriate CMS revenue code for each service or procedure provided. Ensure that the code chosen aligns precisely with the service rendered, avoiding any potential coding errors or discrepancies. Doing so can prevent claim rejections or delays and ensure timely reimbursement.

  • Regular Code Updates and Compliance

Given the dynamic nature of the healthcare industry, CMS revenue codes are subject to periodic updates and revisions. It is crucial to stay up-to-date with the latest coding changes to maintain compliance and optimize revenue. Regularly review CMS guidelines, attend coding workshops, and utilize resources provided by professional organizations to ensure your coding practices align with the most current standards.

  • Documentation Accuracy and Specificity

Accurate and detailed documentation is the cornerstone of proper coding and billing. Ensure your medical records capture the information required to support the assigned CMS revenue codes. Specificity in documentation allows for appropriate code selection and eliminates potential coding ambiguities, reducing the risk of claim denials or audits.

  • Training and Education for Coding Staff

Investing in training and education for coding staff is crucial for accurate CMS revenue code implementation. Provide your coding team with ongoing education, access to industry resources, and opportunities for professional development. Equipping them with the necessary knowledge and skills empowers your organization to optimize revenue generation and minimize coding errors.

  • Regular Audits and Quality Assurance

Performing regular internal audits and quality assurance checks can significantly enhance revenue optimization efforts. Review coding practices, documentation, and billing processes to identify potential improvement areas. Audits also help ensure compliance with CMS guidelines and prevent fraudulent activities, safeguarding your organization’s reputation and financial well-being.

  • Collaborate with Revenue Cycle Management Experts

For organizations facing challenges in revenue optimization, partnering with revenue cycle management experts can provide valuable insights and solutions. These professionals specialize in maximizing revenue through efficient coding, billing, and reimbursement strategies. By leveraging their expertise, you can identify areas for improvement and implement strategies tailored to your organization’s unique needs.

FAQs:

Q1. What happens if I use the wrong CMS revenue code?

Ans. Using an incorrect CMS revenue code can lead to claim denials or delays in reimbursement. Selecting the most accurate code that aligns with the service provided is crucial to avoid financial setbacks.

Q2. How often do CMS revenue codes change?

Ans. CMS revenue codes undergo periodic updates to reflect changes in healthcare services and billing practices. It is essential to stay informed about these changes and update your coding practices accordingly.

Q3. Can CMS revenue codes be used for all healthcare services?

Ans. CMS revenue codes are primarily used for services provided under Medicare and Medicaid. However, depending on the payer’s requirements, they can also be utilized in some private insurance claims.

Q4. Are there any penalties for incorrect CMS revenue code usage?

Ans. Incorrect CMS revenue code usage can result in claim denials, delayed reimbursement, or potential legal consequences. It is crucial to ensure proper code selection to avoid these issues.

Q5. Can I use multiple CMS revenue codes for a single service?

Ans. Multiple CMS revenue codes may sometimes be required to represent a complex service or procedure accurately. Ensure proper code sequencing and documentation to support the use of multiple codes.

Q6. How can I update my coding staff on the latest CMS revenue code changes?

Ans. Provide ongoing training, attend coding workshops, and encourage membership in professional organizations specializing in coding to keep your staff well-informed about the latest CMS revenue code updates.

Conclusion:

CMS revenue codes are vital to unlocking your organization’s revenue optimization potential. Understanding their significance, following best practices, and staying abreast of changes can streamline your billing processes and maximize financial success. Remember to select codes accurately, invest in staff education, and perform regular audits to ensure compliance and prevent revenue leakage. Embrace the power of CMS revenue codes, and watch your organization thrive in the dynamic healthcare landscape.

The list of revenue codes in medical billing plays an important role in hospital claims. Using inappropriate revenue code cause denial of the claim also less payment issued by Insurance companies as well.