Revenue Code 0022: SNF PPS Billing Guide for HIPPS Claims

By DocMBS Billing Team · Last updated: October 2026

Revenue code 0022 is on every Medicare Part A skilled nursing claim, yet it causes a steady stream of returned claims. One missing occurrence code, a unit count that is off by a day, or a HIPPS code that doesn’t match the MDS, and the whole claim stops. With FY 2027 PDPM rates starting October 1, 2026, October claims are the first ones paid at the new rates.

This guide explains exactly how to fill out the 0022 line on a UB-04, how to read the HIPPS code, and how to fix the errors we see most.

What Is Revenue Code 0022?

Revenue code 0022 is the UB-04 revenue code for the Skilled Nursing Facility Prospective Payment System (SNF PPS). In the words of the CMS Claims Processing Manual, it “indicates that this claim is being paid under the SNF PPS.”

The 0022 line does not report charges. It reports how the stay is paid: which PDPM case-mix groups the resident falls into (the HIPPS code) and for how many days. Medicare’s pricer uses those two facts, plus your wage index, to calculate the payment.

• Who uses it: SNFs billing Medicare Part A (type of bill 21X) and hospital swing beds paid under the SNF PPS (type of bill 18X).
• How often: as many times as needed. You add a new 0022 line each time the HIPPS code changes during the billing period.
• What it is not: it is not a room-and-board code. Accommodation charges go on their own revenue lines.

Revenue Code 0022 on the UB-04: Field-by-Field

These are the fields that matter for a Medicare SNF Part A claim with revenue code 0022.

Source: CMS Medicare Claims Processing Manual, Chapter 6, Section 30, and CMS Transmittal R2366OTN (PDPM).

How to Read a PDPM HIPPS Code

Under the Patient Driven Payment Model (PDPM), the HIPPS code on the 0022 line has five characters. Each one points to a payment group.

Assessment indicator values

• 1 = PPS 5-day scheduled assessment
• 0 = Interim Payment Assessment (IPA)
• ZZZZZ = default code, billed when an assessment is late. It pays the default rate, and it does not need an occurrence code 50.

To see what each group pays in FY 2027, see our guide to SNF PDPM urban vs rural rates.

Step-by-Step: Building a Claim With Revenue Code 0022

1. Confirm the MDS was accepted. Pull the HIPPS code from the accepted assessment, not from a draft.
2. Set the type of bill. Use 21X, with the right frequency digit for an admission, interim or discharge claim.
3. Add occurrence span code 70 with the dates of the qualifying hospital stay.
4. Add the accommodation lines with the room revenue code and covered days.
5. Add one 0022 line for each HIPPS code used in the billing period, in date order.
6. Enter units on each 0022 line equal to the covered days at that HIPPS code.
7. Enter $0.00 as total charges on every 0022 line.
8. Add one occurrence code 50 per 0022 line with that assessment’s ARD (not needed for ZZZZZ).
9. Check the math: the 0022 units must add up to the claim’s covered days.
10. Split at the fiscal year if the stay crosses October 1.

Worked Example: One Stay, Two 0022 Lines

Example only. The facility and resident are fictional. Rates are FY 2027 urban rates from the CMS final rule, with the 0.9343 wage index CMS uses in its own example.

A resident is admitted to an urban SNF on October 2, 2026 and is still there on October 31. The SNF sends an interim claim for 30 covered days.

• The 5-day assessment (ARD October 6) gives HIPPS code NHNC1.
• The resident’s needs change, so the team completes an IPA with an ARD of October 16 (day 15). It gives HIPPS code NHNE0. Only the NTA group changed, from C to E.

The 0022 lines

What Medicare’s pricer calculates

Notice that the variable per diem schedule keeps counting from the start of the stay. The new HIPPS code on day 15 does not restart the day count. Days 21–30 also carry resident coinsurance, which is reported separately.

For how each daily rate is built, see our guide to FY 2027 SNF Medicare daily rates.

Common Revenue Code 0022 Errors and How to Fix Them

If corrections pile up, our SNF billing and denial management services can work the RTP queue and fix the setup behind it.

Medicare Advantage, Medicaid and Texas

The rules above are for Original Medicare. Other payers set their own SNF billing rules:

• Medicare Advantage plans often pay SNFs by level of care or a per diem contract, not by PDPM. Some still ask for the HIPPS code on a 0022 line, and some want only room-and-board revenue codes. Check each plan’s provider manual and your contract.
• Texas Medicaid pays nursing facilities under its own state system and through STAR+PLUS managed care, not through Medicare PDPM. Don’t copy your Medicare 0022 setup onto Medicaid claims.
• Dual-eligible residents in Texas: for days 21–100, Medicare is billed first, and the coinsurance crosses over to Texas Medicaid or the resident’s plan.

Keep a payer-by-payer billing grid so your team knows which plans expect 0022 and which don’t.

FAQs

What is revenue code 0022?

Revenue code 0022 is the UB-04 revenue code that shows a claim is being paid under the Skilled Nursing Facility Prospective Payment System. SNFs use it on Medicare Part A claims to report the resident’s PDPM HIPPS code and the number of covered days at that code.

What goes in the units field for revenue code 0022?

The units field holds the number of covered days for that HIPPS code. If a resident has two HIPPS codes in the billing period, each 0022 line shows its own days. Together, the units on all 0022 lines must equal the covered days on the claim.

Why are the charges zero on revenue code 0022?

CMS instructs SNFs to report total charges of zero on revenue code 0022 lines. The 0022 line tells Medicare how to price the stay, using the HIPPS code and days. Your actual charges are reported on the accommodation and ancillary revenue lines.

Is occurrence code 50 required with revenue code 0022?

Yes. Each 0022 line needs a matching occurrence code 50 with the assessment reference date of the assessment that set its HIPPS code. The one exception is the default HIPPS code ZZZZZ, which does not need an occurrence code 50.

What does the HIPPS code ZZZZZ mean?

ZZZZZ is the PDPM default HIPPS code. SNFs bill it for days when the required assessment was late. Those days are paid at the default rate, which is lower than a normal PDPM rate. No occurrence code 50 is needed with ZZZZZ.

Can revenue code 0022 appear more than once on a claim?

Yes. CMS says revenue code 0022 can appear on a claim as often as needed. Add a new 0022 line each time the HIPPS code changes, such as after an Interim Payment Assessment, and list the lines in the order the care was given.

What type of bill is used with revenue code 0022?

SNFs use type of bill 21X for inpatient Part A claims. Hospital swing beds paid under the SNF PPS use type of bill 18X. The last digit of the type of bill shows whether the claim is an admission, interim or discharge claim.

Get Every 0022 Line Right the First Time

Revenue code 0022 is a small line with big consequences. Match the HIPPS code to the accepted MDS, count the days carefully, keep the charges at zero and add an occurrence code 50 for every line. Those four checks prevent most SNF returns.

DocMBS bills Medicare Part A SNF claims every day. Book a free SNF billing review and we’ll check your October claims against the FY 2027 rules.

Sources

• CMS: Medicare Claims Processing Manual, Chapter 6: SNF Inpatient Part A Billing
• CMS: Transmittal R2366OTN: PDPM claims implementation
• CMS: HIPPS codes: uses and structure
• Federal Register: FY 2027 SNF PPS Final Rule (CMS-1843-F)

Last updated: October 2026. This article is for education only. Confirm claim requirements with your Medicare Administrative Contractor and each payer before billing.