UB04 Type of Bill Code 0851: Specialty Facility - Critical Access Hospital

Introduction

Type of Bill Code 0851 identifies a claim submitted by a Specialty Facility specifically categorized as a Critical Access Hospital (CAH). This code is reported in Field 4: Type of Bill.

Usage

This code is used by small, rural facilities that have been officially designated as Critical Access Hospitals by the Centers for Medicare & Medicaid Services (CMS). It indicates that the facility provides 24/7 emergency services and maintains no more than 25 inpatient beds, distinguishing it from standard acute care hospitals.

Billing Impact

The use of code 0851 triggers cost-based reimbursement rather than the standard Inpatient Prospective Payment System (IPPS), significantly altering how the claim is processed and paid.