UB04 Type of Bill Code 0231: Skilled Nursing - Outpatient - Admit through Discharge Claim

Overview

Type of Bill code 0231 is a four-digit alphanumeric code used on the UB-04 claim form. The leading zero is ignored by CMS, and the remaining three digits convey specific information about the facility, type of care, and claim frequency ^[1]. The second digit “2” identifies the facility as a Skilled Nursing Facility (SNF) ^[1]. The third digit “3” indicates that the type of care is outpatient (except clinics) ^[1]. The fourth digit “1” signifies that the claim is an “Admit Through Discharge” claim, meaning it covers the entire episode from admission to discharge in a single submission ^[1]. Therefore, code 0231 is used exclusively for SNF outpatient services that are billed as one complete claim for the full period of care, without interim or partial claims.

When to Use

Code 0231 should be used when a Skilled Nursing Facility provides outpatient services to a Medicare beneficiary and the provider submits a single claim that covers the entire stay from the date of admission through the date of discharge ^[1]. Outpatient care in a SNF typically includes services such as physical therapy, occupational therapy, speech-language pathology, or other Part B covered services that do not require an inpatient admission. The frequency digit “1” (Admit Through Discharge) indicates that no interim claims have been or will be submitted for this episode; the claim is final for that period ^[1]. This code is appropriate only when the entire outpatient encounter is completed and billed in one submission. If the provider needs to bill in multiple parts (e.g., due to benefit period changes or service interruptions), they would use interim frequency codes such as “2” (Interim – First Claim) or “3” (Interim – Continuing Claims) instead ^[1]. Providers must ensure that the facility type digit “2” is correct; using a different facility digit (e.g., “1” for hospital) would be incorrect for a SNF outpatient claim.

Step-by-Step Claim Example

A Skilled Nursing Facility provides outpatient physical therapy to a Medicare beneficiary over a five-day period. The patient is admitted for outpatient services on March 1 and discharged on March 5. The provider decides to bill the entire episode in one claim. On the UB-04 form, the provider enters Type of Bill code 0231. The leading zero is placed in the first position (ignored by CMS) ^[1]. The second digit “2” confirms the facility is a Skilled Nursing Facility ^[1]. The third digit “3” indicates outpatient care ^[1]. The fourth digit “1” signals that this is an admit-through-discharge claim covering the full March 1–March 5 period ^[1]. The provider also completes other required fields such as patient name, HIC number, dates of service, revenue codes (e.g., 0420 for physical therapy), and charges. Because the frequency is “1,” no interim claims are submitted; the entire outpatient episode is settled with this single submission. If the provider later discovers a need to adjust the claim, they would use frequency “7” (Replacement of Prior Claim) or “8” (Void/Cancel of Prior Claim) as appropriate ^[1].

Common Mistakes & Audit Red Flags

One frequent error is using the wrong facility digit. For SNF outpatient claims, the second digit must be “2”; using “1” (hospital) or “3” (home health) will cause the claim to be rejected or misrouted ^[1]. Another common mistake is selecting an incorrect type-of-care digit. Outpatient services require digit “3”; using “1” (inpatient Part A) or “2” (inpatient Part B) is inappropriate for outpatient care and may lead to denial ^[1]. The frequency digit must be “1” only when the claim covers the entire admission-to-discharge period. If the provider submits multiple claims for the same episode (e.g., an interim first claim followed by a final claim), they should use frequency “2” or “4” instead; using “1” for a partial episode is a red flag for auditors ^[1]. Additionally, the leading zero must be present; omitting it can cause the code to be misinterpreted. Providers should also ensure that the dates of service on the claim match the admit-through-discharge period. Any discrepancy between the bill type frequency and the actual service dates may trigger an audit or recoupment. Finally, using code 0231 for inpatient SNF services (which require type-of-care digit “1” or “2”) is a serious billing error.

Related Codes/Fields

The table below lists other Type of Bill codes that are closely related to 0231, based on the same facility and care type but with different frequency digits, as well as codes for SNF inpatient services.

Code	Meaning	Source
0211	Skilled Nursing – Inpatient – Admit Through Discharge	[1]
0221	Skilled Nursing – Inpatient Part B – Admit Through Discharge	[1]
0230	Skilled Nursing – Outpatient – Non-payment/Zero Claim	[1]
0232	Skilled Nursing – Outpatient – Interim – First Claim	[1]
0233	Skilled Nursing – Outpatient – Interim – Continuing Claims	[1]
0234	Skilled Nursing – Outpatient – Interim – Last Claim	[1]
0235	Skilled Nursing – Outpatient – Late Charge Only	[1]
0237	Skilled Nursing – Outpatient – Replacement of Prior Claim	[1]
0238	Skilled Nursing – Outpatient – Void/Cancel of Prior Claim	[1]

These codes share the same facility and care type digits but differ in frequency, allowing providers to accurately report the billing sequence for SNF outpatient services.

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References

[1] Noridian Bill Types — https://med.noridianmedicare.com/web/jea/topics/claim-submission/bill-types