UB04 Revenue Code Code 0440: Speech-Language Pathology

Overview

Revenue code 0440 is the general classification for Speech-Language Pathology (also referred to as Speech Therapy) services on the UB-04 claim form. According to the Centers for Medicare & Medicaid Services (CMS) revenue code guidelines published by Noridian, the 044X series encompasses all speech therapy services, with 0440 representing the “General” category that covers standard speech-language pathology encounters when a more specific subcode does not apply. ^[1] The UB-04 form is used by a defined set of providers including acute inpatient/outpatient hospitals, home health agencies, nursing facilities, and others as outlined in the MassHealth UB-04 Billing Guide. ^[2] The guide notes that up to 22 revenue code lines and associated charges may be entered on a single paper claim, and that separate claim forms must be used for each member. ^[2] Providers must submit claims electronically unless they have received an approved waiver from MassHealth. ^[2] Code 0440 is part of the standardized revenue code set that payers, including MassHealth and Medicare, use to process speech therapy claims.

When to Use

Revenue code 0440 should be used when billing for a general speech-language pathology service that is not specifically defined by one of the subcodes within the 044X series. The Noridian revenue code table lists the following subcategories under 044X: 0440 General, 0441 Visit charge, 0442 Hourly charge, 0443 Group rate, 0444 Evaluation, and 0449 Other. ^[1] Therefore, 0440 is appropriate for a standard speech therapy session that does not involve a separate visit fee, hourly billing, group session, or formal evaluation. For example, a 30-minute individual speech therapy session provided in an outpatient hospital clinic would typically be billed under 0440 if the provider charges a flat fee per session rather than per hour or per visit. According to the MassHealth UB-04 guide, outpatient claims should bundle services onto a single claim form, so all speech therapy charges for a single date of service should be grouped under the appropriate revenue code or codes. ^[2] Providers must ensure the code selected accurately reflects the type of service provided, as using a more specific subcode (e.g., 0442 for hourly) when only a general service was rendered may lead to claim rejection or audit findings. Always verify payer-specific requirements, as some payers may prefer the general code for all speech therapy unless a distinct billing methodology is required.

Step-by-Step Claim Example

Scenario: A hospital-based outpatient clinic provides a 45-minute individual speech therapy session to a MassHealth member. The facility charges a flat session fee of $150. No separate evaluation or group service is performed. Using the MassHealth UB-04 guide, the provider completes an electronic or paper claim (if waiver approved) with a single revenue code line. ^[2]

Step 1: Enter the member’s information and provider details on the UB-04. MassHealth requires a separate claim for each member. ^[2]

Step 2: In Field 42 (Revenue Code), enter 0440. According to Noridian, 0440 is the general revenue code for Speech-Language Pathology. ^[1]

Step 3: In Field 43 (Revenue Description), the provider may enter “Speech Therapy General” or a similar description. Although not required by all payers, this helps clarify the service.

Step 4: In Field 44 (HCPCS/Rate Code/HIPPS Rate Code), enter the appropriate procedure code (e.g., 92507 for speech therapy). The MassHealth guide references a code set for the UB-04; the detailed HCPCS list is found in the guide’s appendix. ^[2]

Step 5: In Field 45 (Service Date), enter the date of the session (e.g., 01/15/2025).

Step 6: In Fields 46 through 49 (Units, Total Charges, etc.), enter 1 unit for a single session and $150.00 as the charge. The MassHealth guide states up to 22 revenue code lines can be included. ^[2]

Step 7: Complete the remaining required fields (e.g., patient control number, provider taxonomy) per MassHealth instructions. ^[2]

This example demonstrates the proper use of 0440 for a straightforward speech therapy visit.

Common Mistakes & Audit Red Flags

Several errors can trigger claim denials or audits when using revenue code 0440. First, using 0440 for a service that requires a more specific subcode—for instance, billing a group therapy session (which should use 0443) as 0440—may result in incorrect payment or recoupment. ^[1] Second, failing to bundle services on a single claim form for outpatient visits: the MassHealth guide instructs providers to bundle services to fit within the 22‑line limit, but some providers erroneously split a single date of service across multiple claims, which can cause duplicate billing flags. ^[2] Third, submitting paper claims for speech therapy without an approved waiver is a violation of MassHealth’s electronic submission policy, leading to automatic rejection. ^[2]

Audit red flags include: billing 0440 with a high number of units that exceed expected norms for a single session; using 0440 when the documentation indicates an evaluation (which should use 0444); and inconsistency between the revenue code and the HCPCS code (e.g., using 0440 with a swallowing evaluation code like 92610, which may be more appropriately billed under 0444 or a separate audiology code). Additionally, when speech therapy is provided in a home health setting, providers must ensure the correct home health revenue code (e.g., 058X) is used; 0440 is only for outpatient hospital or clinic settings. The Noridian list indicates 044X is for “Speech Therapy” generally, but payer-specific guidance should be consulted. ^[1]

Related Codes/Fields

The table below lists the full range of speech therapy revenue codes (044X) and adjacent therapy codes for reference. These codes are drawn from the Noridian revenue code listing. ^[1]

Revenue Code	Description	Notes
0440	Speech Therapy – General	Use for standard sessions not falling under subcodes
0441	Speech Therapy – Visit charge	When a per-visit fee is billed
0442	Speech Therapy – Hourly charge	For services billed per hour
0443	Speech Therapy – Group rate	Group therapy sessions (usually ≥2 patients)
0444	Speech Therapy – Evaluation	Formal assessment/evaluation
0449	Speech Therapy – Other	For miscellaneous speech services
042X	Physical Therapy	Related therapy code series (0420–0429)
043X	Occupational Therapy	Related therapy code series (0430–0439)

Additionally, on the UB-04 claim form, revenue code 0440 is entered in Field 42; the corresponding charge is entered in Field 47 (Total Charges) or the line‑specific charge field. ^[2] The HCPCS code for the specific speech therapy procedure (e.g., 92507, 92524) should appear in Field 44. Providers should refer to the MassHealth code set appendix for complete procedure code lists. ^[2]

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References

[1] Noridian Revenue Codes — https://med.noridianmedicare.com/web/jea/topics/claim-submission/revenue-codes

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