Type of Bill and Facility Type Using PTAN - JE Part A
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 Dec 09 , 2023
