Overview
Patient Discharge Status Code 06 indicates that a patient was discharged or transferred to their home under the care of an organized home health service organization, in anticipation of covered skilled care. This code is used when a patient leaves the hospital but requires ongoing skilled services such as nursing, physical therapy, or occupational therapy provided by a Medicare-certified home health agency. [1]
The code specifically applies when the home health services are organized and coordinated by a formal home health agency, not when the patient simply returns home with informal family care or self-care. The "organized home health service organization" refers to a licensed and certified agency that provides skilled nursing and therapeutic services in the patient's residence. [1]
This code is distinct from Code 01 (discharged to home or self-care), which applies when no organized home health services are anticipated. It also differs from Code 50 (hospice - home), which involves end-of-life palliative care rather than curative or rehabilitative skilled care. [1]
Effective October 1, 2013, a related code (86) was introduced for patients discharged to home under organized home health care with a planned acute care hospital inpatient readmission. Code 06 remains the standard code for home health discharges without a planned readmission. [1]
When to Use
Use Code 06 when a patient is discharged from an inpatient hospital setting and will receive skilled care at home through a formal home health agency. This includes patients who need skilled nursing services (e.g., wound care, IV therapy, medication management) or skilled therapy services (e.g., physical therapy, occupational therapy, speech-language pathology) provided by a Medicare-certified home health organization. [1]
Do not use Code 06 for patients discharged to home without organized home health services, even if they have family caregivers. For those patients, use Code 01 (discharged to home or self-care). Also avoid using Code 06 when the patient is discharged to a skilled nursing facility (use Code 03) or to hospice care at home (use Code 50). [1]
This code applies to all payer types, including Medicare, Medicaid (MassHealth), and commercial insurance. Providers should verify payer-specific requirements, as some payers may require additional documentation of the home health plan of care. [2]
Step-by-Step Claim Example
Scenario: A 72-year-old patient is discharged from an acute care hospital following hip replacement surgery. The patient will return home with home health services including physical therapy and skilled nursing for wound care, arranged through a Medicare-certified home health agency.
Step 1: Complete the patient demographic information in Fields 1-13 of the UB-04 form, including patient name, address, date of birth, and insurance information. [2]
Step 2: In Field 17 (Patient Discharge Status), enter "06" to indicate discharge to home under organized home health care. Ensure the code is legible and correctly positioned in the field. [1]
Step 3: Complete Fields 18-28 with admission and discharge dates. The discharge date should match the date the patient left the facility and home health services began. [2]
Step 4: In Field 42 (Revenue Codes), list all applicable revenue codes for the inpatient stay, such as 0100 (all-inclusive room and board) and 0250 (pharmacy). [2]
Step 5: In Field 66 (Diagnosis Codes), enter the principal diagnosis (e.g., M16.1 for hip osteoarthritis) and any secondary diagnoses. [2]
Step 6: In Field 76 (Attending Physician), enter the attending physician's NPI number and name. [2]
Step 7: Submit the claim electronically (or on paper if a waiver has been granted) to the appropriate payer. For MassHealth, claims must be submitted electronically unless a waiver has been approved. [2]
Common Mistakes & Audit Red Flags
Mistake 1: Using Code 06 when no organized home health agency is involved. If the patient simply returns home with family care, use Code 01. Auditors will flag claims where home health services are not documented in the medical record. [1]
Mistake 2: Confusing Code 06 with Code 50 (hospice - home). Code 06 is for skilled, curative, or rehabilitative care. Code 50 is for end-of-life palliative care. Using the wrong code can result in claim denials or overpayment recovery. [1]
Mistake 3: Failing to update the discharge status when the patient is readmitted within 30 days. If a planned readmission is anticipated, use Code 86 instead of Code 06. Using Code 06 for a planned readmission may trigger an audit for potential billing errors. [1]
Mistake 4: Inconsistent documentation. The medical record must clearly document that home health services were arranged and that the patient was discharged to home for that purpose. Auditors will compare the discharge status code with nursing notes, discharge planning records, and home health referral forms. [2]
Mistake 5: Using Code 06 for observation stays. This code is intended for inpatient discharges only. Observation patients should use appropriate outpatient discharge status codes. [1]
Related Codes/Fields
| Field/Code | Description | Relationship to Code 06 |
|---|---|---|
| Code 01 | Discharged to home or self-care | Use when no organized home health services are provided |
| Code 03 | Discharged/transferred to SNF | Use when patient goes to skilled nursing facility instead of home |
| Code 50 | Hospice - home | Use for end-of-life palliative care at home, not skilled care |
| Code 86 | Home under home health with planned readmission | Use when a planned acute care readmission is expected |
| Field 17 | Patient Discharge Status | The field where Code 06 is entered on the UB-04 |
| Field 42 | Revenue Codes | Must align with inpatient services provided before discharge |
| Field 66 | Diagnosis Codes | Principal and secondary diagnoses supporting the need for home health |
[1] [2]
References
[1] Noridian Patient Status — https://med.noridianmedicare.com/web/jea/topics/claim-submission/patient-discharge-status-codes
[2] MassHealth UB-04 Guide — https://www.mass.gov/doc/ub-04-billing-guide-0/download
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Last Updated: 2026-06-03
Sources: CMS Pub. 100-04 Chapter 25, NUBC Official UB-04 Manual, Medicare Contractor Bulletins (Noridian, Palmetto, CGS)