Common UB-04 Codes for Behavioral Health Services

by  Wyn Staheli, Director of Research
October 1st, 2016

The UB-04 is the claim form to be used for billing facility services. This article lists some of the common codes that behavioral healthcare providers would use when billing these types of services. Always verify payer policies regarding their preferred codes.

Note: A more comprehensive list of codes for the UB-04 claim form is found in Resource 458.

FL 5 — Type of Bill

013 Hospital outpatient
065 Intermediate care, level 1
066 Intermediate care, level 2
073 Freestanding clinic
074 Outpatient rehabilitation facility
076 Community Mental Health Center (CMHC)
077 Federally Qualified Health Center (FQHC)
086 Residential facility

FLs 18 – 28 — Condition Codes

A3 Special Federal Funding
A5 Disability
29 Disabled Beneficiary and/or Secondary to Medicare
31 Patient is a Student (Full-Time — Day)
31 Patient is a Student (Part Time)
39 Private Room Medically Necessary
41 Partial Hospitalization
48 Psychiatric Residential Treatment Centers for Children and Adolescents (RTCs)

FL 42 — Revenue Codes

0513 Psychiatric Clinic
0526 Urgent Care Clinic
0900 Behavior Health Treatments/Services — General Classification
0901 Electroshock Treatment
0902 Milieu Therapy
0903 Play Therapy
0904 Activity Therapy
0905 Intensive Outpatient Services-Psychiatric
0906 BH/Intensive Outpatient/Psych
0907 BH/Intensive Outpatient/Chemical Dependency
090X Behavior Health Treatments/Services (Also see 091X, an extension of 090X)
0911 Behavior Health: Rehabilitation
0912 Behavior Health: Partial Hospitalization* — Less Intensive
0913 Behavior Health: Partial Hospitalization* — Intensive
0914 Individual Therapy
0915 Group Therapy
0916 Family Therapy
0917 Bio Feedback
0918 Behavior Health: Testing
0919 Other Behavior Health Treatments/Services
091X Behavioral Health Treatment/Services — Extension of 090X

*NOTE: Medicare does not recognize codes 0912 and 0913 services under its partial hospitalization program