UB04 Type of Bill Code 0341: Home Health - Outpatient (Other) - Admit through Discharge Claim

Overview

Type of Bill (TOB) code 0341 is a four-digit alphanumeric code used on the UB-04 claim form. The leading zero is ignored by CMS. The second digit (3) indicates the facility type is Home Health, the third digit (3) indicates the type of care is Outpatient (i.e., “Other” for home health), and the fourth digit (1) indicates the frequency is Admit through Discharge, meaning this claim covers the entire episode of care from admission to discharge. ^[1]

Home health agencies use this code when billing for outpatient services provided to a patient who is not in an inpatient setting, and the claim incorporates all services rendered during a single home health stay. The “Other” designation in TOB 0341 refers to outpatient services that are not classified as inpatient or other categories (e.g., Part A or Part B under different third digits). This code is distinct from other home health TOBs such as 032x (home health services that are not outpatient) or 033x (home health outpatient interim claims). ^[1]

Providers must follow the standard UB‑04 completion rules, including the general instructions provided by payers such as MassHealth. For example, MassHealth requires all claim submissions to be electronic unless a paper waiver is approved, and paper claims must use the UB‑04 form with correct code sets. ^[2]

When to Use

TOB 0341 should be used when a home health agency (Type 3) provides care that is classified as “Outpatient” (Type of Care 3) and the claim reflects the entire patient episode from admission through discharge (Frequency 1). ^[1]

This code is appropriate for home health services that are not considered inpatient (e.g., Part A inpatient) or other Part B (like therapy in a clinic). Typical situations include:

• A home health agency provides skilled nursing, physical therapy, or occupational therapy on an outpatient basis (patient not admitted as an inpatient) and the episode ends within the billing period.
• The claim covers all services from the start of care (admission) to the end of care (discharge) without interim billing. If the episode spans multiple billing periods or requires interim claims, use 0342, 0343, or 0344 instead. ^[1]

For home health agencies that use PPS (Prospective Payment System), the fourth digit “9” (Final claim for Home Health PPS Period) may be relevant, but 0341 is for a single, complete episode that does not involve PPS periods. ^[1]

Providers should verify payer-specific billing rules. For example, MassHealth’s UB‑04 guide instructs providers to complete all required fields accurately, and the code set must match the service provided. ^[2]

Step-by-Step Claim Example

A home health agency provides outpatient therapy (physical and occupational therapy) to a patient over a two‑week period. The patient is admitted on April 1 and discharged on April 14. The agency bills a single claim for all services.

Step 1: Complete Form Locator (FL) 4 – Type of Bill. Enter 0341.

• First digit (0) – leading, ignored by CMS.
• Second digit (3) – Home Health.
• Third digit (3) – Outpatient (Other).
• Fourth digit (1) – Admit through Discharge. ^[1]

Step 2: Enter the provider information, patient demographics, and other required fields (e.g., FL 1, FL 2, FL 3, FL 5–10) per UB‑04 instructions. For MassHealth, ensure the member’s ID and TPL information are included. ^[2]

Step 3: In FL 6 (Statement Covers Period) enter from 0401 (April 1) to 0414 (April 14) consistently with the admit and discharge dates.

Step 4: In FL 11 (Patient Name) and FL 12 (Admission Date) use April 1. FL 13 (Discharge Date) use April 14.

Step 5: In FL 42–49 enter revenue codes for the therapy services (e.g., 0421 for physical therapy, 0431 for occupational therapy) with associated charges, units, and HCPCS codes.

Step 6: In FL 50 (Payer) list the primary payer (e.g., Medicare, MassHealth). For MassHealth, use the appropriate payer ID as instructed by the MassHealth UB‑04 guide. ^[2]

Step 7: Submit the claim electronically (or on paper if waiver granted). Ensure the claim reflects “Admit through Discharge” – only one claim for the whole episode.

Common Mistakes & Audit Red Flags

• Using the wrong third digit: Some providers incorrectly use “2” (Inpatient Part B) or “1” (Inpatient Part A) for home health outpatient services. Only third digit “3” is correct for outpatient (other). ^[1]
• Incorrect frequency digit: Using “2,” “3,” or “4” (interim) when the claim covers the full episode. TOB 0341 requires frequency 1. If the episode extends beyond a billing cycle, use the appropriate interim code (e.g., 0342, 0343, 0344). ^[1]
• Mismatch between TOB and admission/discharge dates: The claim must reflect the same period as FL 6 (Statement Covers Period) and FL 12/13. Auditors often check for consistency.
• Missing required patient or provider information: According to the MassHealth UB-04 guide, incomplete fields can cause rejections or delays. ^[2]
• Billing multiple claims for the same episode under different TOBs: Claim 0341 is for one complete episode; if multiple claims are submitted, use interim or split billing correctly.
• Failure to follow payer-specific instructions: For MassHealth, paper claims are only accepted with an approved waiver. Electronic submission is mandatory unless waived. ^[2]

Related Codes/Fields

Field/Code	Description	Source
0342	Home Health – Outpatient (Other) – Interim – First Claim	[1]
0343	Home Health – Outpatient (Other) – Interim – Continuing Claims	[1]
0344	Home Health – Outpatient (Other) – Interim – Last Claim	[1]
0349	Home Health – Outpatient (Other) – Final claim for Home Health PPS Period	[1]
0321	Home Health – Inpatient Part A – Admit through Discharge	[1]
0331	Home Health – Outpatient – Admit through Discharge (Note: 0331 is outpatient but without “Other” – see payer definitions)	[1]
FL 4	UB-04 Form Locator 4 – Type of Bill	[2]
FL 6	Statement Covers Period (From/Through)	[2]
FL 12	Admission Date	[2]
FL 13	Discharge Date	[2]

Note: Code definitions for TOB 0321 and 0331 are derived from the type‑of‑facility and type‑of‑care structure provided in ^[1]. The “Other” designation in third digit 3 is distinct from standard outpatient (third digit 3 without “Other”) when used with certain facility types; consult payer guidelines for precise definitions.

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References

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

[2] MassHealth UB-04 Guide — https://www.mass.gov/doc/ub-04-billing-guide-0/download