Provider Manual Update

Date: 08/07/26

Provider billing for type of bill (TOB) 86x has varied significantly. A provider manual update was completed to clarify inpatient billing requirements for 86x. Further claims review with our configuration partners also identified variability in provider billing across inpatient, outpatient, and residential treatment center (RTC) TOBs. To support clearer guidance, a BH TOB scenario document has been created covering the following:

• Inpatient TOB and revenue code scenarios
  • 11x
• Residential treatment center (RTC) TOB and revenue code scenarios
  • 86x

• Outpatient TOB and revenue/procedure code scenarios
  • 13x
  • 76x