Type of Bill and Facility Type Using PTAN

When billing Medicare for outpatient or inpatient claim, the last four digits of a Provider Transaction Access Number (PTAN) determines which type of bill should be submitted.

Provider Transaction Access Number (Last Four Digits) Type of Bill (TOB)
0001 - 0999, 1200 - 1399, 2000 - 2299, 3025 - 3099, 3300 - 3399, 4000 - 4499, S001 - S999, T000 - T999, V001 - V999, 3025 - 3099, RXXX, TXXX, MXXX, Z300 - Z399 (position 6 may also = E or F) 11X
0001 - 0999, 1200 - 1399, 2000 - 2299, 3025 - 3099, 3300 - 3399, 4000 - 4499, S001 - S999, T000 - T999, V001 - V999, 3025 - 3099, RXXX, TXXX, MXXX 12X
0001 - 0999, 1200 - 1299, 1800 - 1989, 1990 - 1999, 2000 - 2299, 3025 - 3099, 3300 - 3399, 4000 - 4499, V001 - V999 (position 6 may also = E or F) 13X
0001 - 0999, 1200 - 1399, 1300 - 1399, 1800 - 1989, 1990 - 1999, 2000 - 2299, 3025 - 3099, 3300 - 3389, 4000 - 4499, V001 - V999 (position 6 may also = E or F) 14X
U001 - U999, W001 - W999, Y001 - Y999, Z300 - Z399 18X
5000 - 6499, Y001 - Y999, Z300 - Z399 21X
1800 - 1989, 5000 - 6499, W000 - W999 22X
5000 - 6499 23X
5000 - 6499, U000 - U999, Y001 - Y999, Z300 - Z399 28X
3400 - 3499, 3975 - 3999, 8500 - 8999 71X
0001 - 0999, 1200 - 1299, 2300 - 2999, 3300 - 3399, 3500 - 3799 72X
4600 - 4799, 4900 - 4999, 6500 - 6899 74X
3200 - 3299, 4500 - 4599, 4800 - 4899, 6500 - 6989 75X
4600 - 4799, 4900 - 4999 76X
1800 - 1989, 1000 - 1199 77X
1800 - 1989, 1300 - 1399 85X

 

When billing Medicare for outpatient or inpatient claim, the last four digits of a Provider Transaction Access Number (PTAN) determines the provider's association with a specific facility type or department.

Provider Transaction Access Number (Last Four Digits) Facility Type
1300 - 1399, Z300 - Z399, MXXX Critical Access Hospital (CAH) Facility
3300 - 3399 (Excluded from Prospective Payment System (PPS)) Children's Hospital
4000 - 4499, M000 - M999, S000 - S999 Inpatient Psychiatric Hospitals (IPF)
1400 - 1499, 4600 - 4799, 4900 - 4999 Community Mental Health Centers (CMHC)
3200 - 3299, 4500 - 4599, 4800 - 4899 Comprehensive Outpatient Rehabilitation Facilities (CORF)
1990 - 1999, 6990 - 6999 Religious Non-Medical Healthcare Institution
000E - 999E Emergency
2300 - 2999, 3500 - 3799 End Stage Renal Disease (ESRD) Facilities
000F - 999F Federal
1000 - 1199, 1800 - 1989 FQHC
0001 - 0999 Hospital
3025 - 3099, T000 - T999, 3025 - 3099, RXXX, TXXX Inpatient Rehabilitation Facility (IRF) PPS
2000 - 2299 Long-Term Care Hospital(LTCH) PPS
6500 - 6989 Outpatient Physical Therapy (OPT) Services
S001 - S999 Psychiatric Units
4000 - 4499 Psychiatric Hospitals
3025 - 3099 REHAB Hospital
T001 - T999 Rehabilitation Units
0001 - 0999 PPS
3400 - 3499, 3800-3999, 8500-8999 Rural Health Clinic (RHC)
5000 - 6499 Skilled Nursing Facility (SNF)
U001 - U999 Swing Bed Short-Term Hospitals
W001 - W999 Swing Bed Long Term Care Hospitals
Y001 - Y999 Swing-Bed Rehabilitation Hospitals
Z300 - Z399 Swing-Bed Critical Access Hospitals

 

Last Updated Wed, 10 Apr 2019 12:45:38 +0000