UB04 Revenue Code Code 0550: Skilled Nursing

Overview

Revenue code 0550 is defined as “Skilled Nursing – General” within the 055X series ^[1]. This code represents general skilled nursing charges that are not specifically classified as a visit charge (0551) or an hourly charge (0552) ^[1]. However, the Noridian list establishes 0550 as the general option within skilled nursing, making it appropriate when no subcode (e.g., 0551, 0552, or 0559) better describes the service ^[1].

When to Use

Use revenue code 0550 when billing for skilled nursing services that are not billed on a per-visit or per-hour basis ^[1]. The Noridian list explicitly distinguishes 0550 as “General” and provides subcodes 0551 (Visit charge) and 0552 (Hourly charge) for more granular billing ^[1]. Therefore, providers should only use 0550 when the billing method does not align with a visit or hourly structure. The MassHealth UB-04 guide identifies nursing facilities as one of the provider types required to use the UB-04 form, confirming that skilled nursing services may be submitted under this code ^[2]. Additionally, the code is part of the revenue code series that appears in the “Code Sets for the UB-04 Claim Form” section of the MassHealth guide, indicating its acceptance for MassHealth claims ^[2]. Always verify payer-specific billing requirements, as some payers may mandate the use of subcodes when applicable. When in doubt, consult the full revenue code list from Noridian to confirm the correct subcode for the service rendered ^[1].

Step-by-Step Claim Example

Consider a patient residing in a skilled nursing facility (SNF) for 30 days. The facility bills a flat daily rate for skilled nursing supervision, separate from room and board. To submit this on a UB-04 claim, the provider would enter revenue code 0550 in Field 42 on line 1, with the total charge for the 30 days in the corresponding charge column. If the patient also has a semiprivate room, the provider would add revenue code 0120 (Room & Board – Semiprivate) on line 2. The Noridian list defines 0550 as “Skilled Nursing – General,” confirming its use for this flat daily charge ^[1]. The provider must ensure that no subcode such as 0551 (Visit charge) or 0552 (Hourly charge) applies; if the service were billed per nursing visit, 0551 would be used instead ^[1]. After completing all revenue lines, the provider totals the charges and submits the claim to MassHealth (or another payer) using the UB-04 form. The MassHealth guide states that “for inpatient claims that exceed 22 lines, submit an electronic claim” ^[2]. In this simple example, only two lines are needed, so a paper claim is acceptable if a waiver is approved. This example demonstrates the typical application of 0550 for general skilled nursing charges.

Common Mistakes & Audit Red Flags

One frequent mistake is using revenue code 0550 when the service should be billed under a subcode such as 0551 (Visit charge) or 0552 (Hourly charge) ^[1]. Payers often reject or recoup payments if a more specific code exists and was not used. Auditors also look for unbundling of services that should be combined; the MassHealth guide advises that “for outpatient claims, bundle services to submit the claim on a single form” ^[2]. While this applies to outpatient claims, inpatient claims with more than 22 revenue lines must be submitted electronically, and using paper for such claims is a compliance risk ^[2]. Another red flag is using 0550 for services that are not skilled nursing, such as personal care or custodial care. The Noridian list designates 0550 only for skilled nursing; other revenue codes (e.g., 057X for Home Health Aide) cover different service types ^[1]. Providers should also ensure that the reported units or charges are consistent with the billing methodology; for 0550, the charge should reflect a general daily or flat amount rather than a per-visit or per-hour calculation. Finally, failing to include supporting documentation or prior authorization numbers (if required by the payer) can trigger denials. By adhering to the correct subcode selection and claim form limits, providers can minimize audit exposure.

Related Codes/Fields

The table below lists revenue codes directly related to 0550, as well as the field in which they appear on the UB-04 form. All codes are sourced from the Noridian Revenue Codes list, and field information comes from the MassHealth UB-04 guide.

Code / Field	Description	Source
0550	Skilled Nursing – General	[1]
0551	Skilled Nursing – Visit charge	[1]
0552	Skilled Nursing – Hourly charge	[1]
0559	Skilled Nursing – Other	[1]
Field 42	Revenue Code (location on UB-04 form)	[2]

The Field 42 entry is derived from the MassHealth guide, which explains how to complete the UB-04 form including revenue code placement ^[2]. Additional related fields such as Field 43 (Revenue Description) and Field 44 (HCPCS/Rates) may also be populated when using 0550, though the MassHealth guide does not provide specific instructions for those fields in relation to this code. Providers should refer to the complete UB-04 instruction manual for full field requirements.

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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