Type of Bill (TOB) is a three-digit code (commonly displayed as a four-digit code with a leading zero on electronic claims) used on institutional healthcare claims to identify the type of healthcare facility, the category of care provided, and the billing frequency. TOB codes are primarily used on the UB-04 (CMS-1450) claim form submitted by hospitals, skilled nursing facilities, home health agencies, hospice providers, and other institutional healthcare facilities.
The Type of Bill (TOB) helps Medicare, Medicaid, and commercial insurance companies understand what type of institution submitted the claim, what services were provided, and whether the claim is an original, interim, replacement, or corrected claim.
Understanding TOB codes is essential for medical billers, payment posting specialists, claim submission teams, and Revenue Cycle Management (RCM) professionals who work with institutional billing.
What is Type of Bill (TOB)?
A Type of Bill (TOB) is a numeric code reported on institutional claims that identifies:
- The type of healthcare facility.
- The classification of care.
- The billing frequency.
TOB codes allow insurance companies to process institutional claims accurately and determine the appropriate reimbursement.
Why is TOB Important?
Type of Bill codes help:
- Identify the billing facility.
- Differentiate inpatient and outpatient claims.
- Identify original, corrected, replacement, and void claims.
- Improve claim processing accuracy.
- Reduce claim denials.
- Ensure compliance with Medicare billing guidelines.
- Support efficient Revenue Cycle Management.
Where is TOB Used?
Type of Bill codes are used on:
- UB-04 (CMS-1450) Claim Form
- Electronic 837I Institutional Claims
- Medicare Institutional Claims
- Medicaid Institutional Claims
- Commercial Institutional Claims
Note: TOB is not used on professional CMS-1500 claims.
Structure of a Type of Bill Code
A TOB consists of three digits, often displayed with a leading zero as four digits.
Example:
0131
Where:
- 0 – Leading zero (placeholder)
- 1 – Facility Type
- 3 – Bill Classification
- 1 – Claim Frequency
First Digit – Facility Type
The first meaningful digit identifies the healthcare facility.
| Code | Facility Type |
|---|---|
| 1 | Hospital |
| 2 | Skilled Nursing Facility (SNF) |
| 3 | Home Health Agency |
| 4 | Religious Nonmedical Healthcare Institution |
| 5 | Intermediate Care Facility |
| 6 | Clinic |
| 7 | Special Facility |
| 8 | Hospice |
| 9 | Reserved |
Second Digit – Bill Classification
The second digit identifies the type of care.
Common classifications include:
| Code | Classification |
| 1 | Inpatient |
| 2 | Inpatient Part B |
| 3 | Outpatient |
| 4 | Other |
| 5 | Intermediate Care |
| 7 | Replacement of Prior Claim (facility-specific use may vary) |
The available classifications vary depending on the facility type.
Third Digit – Claim Frequency
The third digit indicates the claim frequency.
| Code | Meaning |
| 1 | Admit Through Discharge Claim |
| 2 | Interim – First Claim |
| 3 | Interim – Continuing Claim |
| 4 | Interim – Last Claim |
| 5 | Late Charge Only |
| 7 | Replacement or Corrected Claim |
| 8 | Void or Cancel Claim |
These codes inform the payer whether the claim is original, corrected, interim, or void.
Common Type of Bill Codes
0111
Hospital Inpatient – Admit Through Discharge
Used for inpatient hospital claims covering the entire stay.
0131
Hospital Outpatient – Original Claim
One of the most common TOB codes for hospital outpatient services.
0211
Skilled Nursing Facility – Inpatient
Used for skilled nursing facility claims.
0321
Home Health Agency – Original Claim
Used for home healthcare services.
0811
Hospice – Non-Hospital
Used for hospice services.
TOB and Revenue Cycle Management (RCM)
TOB codes support several stages of Revenue Cycle Management, including:
- Charge Capture
- Claim Preparation
- Claim Submission
- Insurance Adjudication
- Payment Posting
- Denial Management
- Accounts Receivable (AR) Follow-up
Correct TOB selection helps improve claim acceptance and reimbursement.
TOB and UB-04 Claim Form
The UB-04 (CMS-1450) claim form is used by institutional providers.
Important fields include:
- Type of Bill (TOB)
- Revenue Codes
- Admission Date
- Discharge Date
- Patient Status
- Diagnosis Codes (ICD-10-CM)
- Procedure Codes (when applicable)
- Charges
- Provider Information
The TOB is one of the most important fields on the UB-04 claim.
TOB vs POS
| Type of Bill (TOB) | Place of Service (POS) |
| Used on UB-04 institutional claims | Used on CMS-1500 professional claims |
| Identifies facility, care type, and claim frequency | Identifies where the service was performed |
| Used mainly by hospitals and facilities | Used mainly by physicians and other practitioners |
Common TOB Errors
Avoid these common mistakes:
- Incorrect facility type.
- Incorrect bill classification.
- Wrong claim frequency.
- Using TOB on CMS-1500 claims.
- Submitting an original claim instead of a corrected claim.
- Using outdated billing guidelines.
These errors may result in claim rejections or payment delays.
Best Practices
To improve TOB accuracy:
- Verify the facility type.
- Select the correct bill classification.
- Use the appropriate claim frequency code.
- Review Medicare billing guidelines.
- Validate claims before submission.
- Stay updated with CMS billing requirements.
Benefits of Understanding TOB
Learning Type of Bill codes helps professionals:
- Improve claim accuracy.
- Reduce claim denials.
- Speed up reimbursement.
- Ensure Medicare compliance.
- Improve institutional billing knowledge.
- Strengthen Revenue Cycle Management skills.
Frequently Asked Questions
What is a Type of Bill (TOB)?
A Type of Bill is a code used on institutional claims to identify the healthcare facility, type of care, and claim frequency.
Where is TOB reported?
TOB is reported on the UB-04 (CMS-1450) claim form and electronic 837I institutional claims.
Is TOB used on CMS-1500 claims?
No. CMS-1500 claims use Place of Service (POS) codes instead of Type of Bill codes.
What does TOB 0131 mean?
- 01 – Hospital
- 3 – Outpatient
- 1 – Original admit-through-discharge claim
It is commonly used for hospital outpatient billing.
What is the difference between TOB 0131 and 0137?
- 0131 – Original outpatient claim.
- 0137 – Replacement (corrected) outpatient claim.
Conclusion
Type of Bill (TOB) is a critical element of institutional medical billing. It identifies the healthcare facility, classifies the type of care, and indicates the claim frequency, enabling insurance companies to process institutional claims accurately. Understanding TOB codes helps reduce claim denials, improve reimbursement, and ensure compliance with Medicare and other payer requirements. For professionals involved in hospital billing, skilled nursing, home health, or hospice billing, mastering TOB codes is an essential part of successful Revenue Cycle Management.