Questions billers ask › What does revenue code 0022 mean for SNF PPS claims?
What does revenue code 0022 mean for SNF PPS claims?
The rule, word for word
“SNFs and hospital swing bed providers are required to report inpatient Part A PPS billing data as follows. Refer to the Medicare Claims Processing Manual, Chapter 25, “Completing and Processing the Form CMS-1450 Data Set,” for a description of claim data elements. • In addition to the required fields identified in Chapter 25, SNFs must also report occurrence span code “70” to indicate the dates of a qualifying hospital stay of at least three consecutive days which qualifies the beneficiary for SNF services. • Separate bills are required for each Federal fiscal year for admissions that span the annual update effective date (October 1). • Use Type of Bill 21X for SNF inpatient services or 18X for hospital swing bed services. • Revenue Code 0022. This code indicates that this claim is being paid under the SNF PPS. This revenue code can appear on a claim as often as necessary to indicate different HIPPS Rate Code(s) and assessment periods. • Effective for claims with dates of service on or after January, 1 2011, there must be an occurrence code 50 (assessment date) for each assessment period represented on the claim with revenue code 0022. The date of service reported with occurrence code 50 must contain the ARD. An occurrence code 50 is not required with default HIPPS code AAAxx (where ‘xx’ equals varying digits) or ZZZZZ October 1, 2019 and after. In addition, for OMRA related [...]”
Captured2026-05-24
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What our AI found in the sources
Revenue code 0022 is used on SNF (Type of Bill 21X) and hospital swing-bed (TOB 18X) claims to signal that the claim is paid under the SNF Prospective Payment System (SNF PPS). It can appear multiple times on one claim to report different HIPPS Rate Codes and assessment periods, and each 0022 line must carry a 5-digit HIPPS code in the HCPCS/Rates field (RUG group + assessment indicator under the former RUG-IV model, or the equivalent PDPM HIPPS code since October 1, 2019). Total charges on revenue code 0022 lines should be zero, and for dates of service on/after January 1, 2011 each assessment period reported under 0022 generally requires a corresponding occurrence code 50 with the assessment reference date.
Also cited
Captured2026-05-24
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Captured2026-05-24
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If this comes up on one of your claims
The quoted paragraph above is what you would put in the appeal or the audit file, with its citation and dates. Verbatim does not tell you how to bill; it shows you the rule as published so the decision is yours and the proof is in writing.
Ask it your own question and get the same thing back: the governing rule, quoted, with a citation that still verifies later.
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