Claim Facility Type Code (Encounter)

SAS Name
CLM_FAC_TYPE_CD

The type of facility. 

Comments

This field, in combination with the service classification type code (variable called CLM_SRVC_CLSFCTN_TYPE_CD) indicates the “type of bill” for an institutional claim.  Many different types of services can be billed on a Part A or Part B institutional claim, and knowing the type of bill helps to distinguish them.     

The type of bill is the concatenation of two variables: 

  • facility type (CLM_FAC_TYPE_CD) 
  • service classification type (CLM_SRVC_CLSFCTN_TYPE_CD)

Note that sometimes 3 variables are used for “type of bill”, where the 3rd digit is the claim frequency code (CLM_FREQ_CD).  

Source: Medicare Advantage Organizations (MAOs) 

Code Code value
1 Hospital
2 Skilled Nursing Facility (SNF)
3 Home Health Agency (HHA)
4 Religious Non-medical (hospital)
7 Clinic services or hospital-based renal dialysis facility
8 Ambulatory Surgery Center (ASC) or other special facility (e.g. hospice)