In the world of hospital billing, using Revenue Code 0120 is like using a special key for semi-private rooms. Understanding this code is a wonderful way to make the billing process smooth and easy. It helps ensure the hospital receives payment for the great care they provide.

Imagine every claim tells a perfect story of the services provided, and the review process glides along happily. It feels amazing! This is totally possible when you use the right approach with Revenue Code 0120.

In this guide, we will explore:

  • What Revenue Code 0120 is and when to use it.

  • How to create a perfect bill.

  • The payment amounts from different insurance friends.

What is Revenue Code 0120?

Revenue Code 0120 is a special label for a semi-private hospital room. This simply means a room with two beds!

This code acts like a helper. It tells the insurance company, "The patient stayed in a shared room to get better." When you use this code, it helps everything move quickly so payment arrives on time.

Quick Facts:

  • 0120: The code you use for a room with two beds.

  • The first part (012): Points to the shared room.

  • The last part (0): Shows the patient is getting medical care to become healthy.

When to Use Revenue Code 0120

Use this code when everything matches perfectly! You need it for:

  • Staying Overnight: The patient is at the hospital for a sleepover stay.

  • Shared Room: The patient is in a room with two beds.

  • Getting Better: The patient is healing, recovering from surgery, or getting treatment to feel strong again.

Example:

Imagine a nice person fixes their hip and stays in a shared room for 5 days to rest. You use Revenue Code 0120 for each of those 5 days!

Finding the Right Code for Other Rooms

Sometimes a patient stays in a different kind of spot. For those times, we have other great codes to use!

  • Private Room (One Bed): Use Revenue Code 0110.

  • Special Care (ICU): Use Revenue Code 0200.

  • Nursery: Use Revenue Code 0170.

  • Just Visiting: If they go home the same day, use a different plan for daytime visits.

Why Getting It Right is Awesome

Using the correct code is fantastic because it helps the claim match the service exactly. This makes the process easy and keeps payments flowing fast! It helps everyone work together happily.

Payment Rates for Revenue Code 0120

Different insurance plans provide different amounts of support. Here are some average numbers for shared room stays based on helpful data:

  • Blue Cross Blue Shield: $17,073.66

  • United Healthcare: $5,481.98

  • Aetna: $14,465.61

  • Cigna: $26,803.77

Note: These numbers are a starting point. Payments can change based on where the hospital is and what the patient needs. Government programs like Medicare and Medicaid also contribute their own helpful amounts, usually between $3,000 and $8,000.

How to Bill Revenue Code 0120 Successfully

Billing is fun and straightforward when you follow these happy steps!

1. Confirm Coverage

Make sure the patient’s insurance plan supports stays in a shared room.

  • Check the plan: Confirm they cover overnight stays.

  • Check the time: See how many days the plan allows.

  • Ask first: Sometimes you need to get a "Yes" from the insurance before the patient stays.

2. Use the UB-04 Form

This is the standard form for hospital billing. It’s like a report card for the visit!

  • Revenue Code: This is where you write 0120.

  • Diagnosis Codes: These explain why the patient is visiting.

  • Procedure Codes: These describe the helpful treatments given.

3. Tell the Full Story

Even though Code 0120 is for the room, adding other codes helps explain the stay clearly.

  • Diagnosis Codes: Describe the condition (like "fixing a hip").

  • Procedure Codes: Describe the work done (like the surgery itself).

    This helps the insurance understand the great care provided.

4. Count the Days (Units)

In the "Units" spot on the form, write how many days the patient stayed in the room.

  • If they stayed for 3 days, write 3.

  • This number helps calculate the total amount correctly!

5. Do the Math

Now, calculate the total price for the room.

  • Multiply the daily price by the number of days.

  • Example: $1,200 (daily price) x 3 (days) = $3,600.

  • Write this number in the "Total Charges" spot.

6. Fill the Form Carefully

  • Revenue Code Spot: Enter 0120.

  • Units Spot: Enter the number of days.

  • Total Charges Spot: Enter the final price.

7. Match the Notes

Make sure the doctor's notes and the bill tell the same positive story.

  • The notes should say, "The patient stayed in a shared room to recover."

  • This verifies that the patient received the right care.

8. Check Special Requests

Look to see if the insurance company has any specific wishes for the claim. Providing exactly what they need helps everything go well.

9. Send the Claim!

Once everything looks perfect, send it off! You can do this on a computer or by mail. Keep a copy for your records to stay organized.

Conclusion

Using Revenue Code 0120 correctly is a super skill! By understanding the code, filling out the form nicely, and double-checking your work, you set the stage for success. This ensures smooth processing and quick payments. You can confidently bill for shared rooms and keep the hospital running perfectly!

Sources:

National Uniform Billing Committee (NUBC)
https://www.nubc.org/

CMS Medicare Claims Processing Manual – Chapter 25
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c25.pdf

CMS Medicare Benefit Policy Manual – Chapter 1
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c01.pdf

BellMedEx - Revenue Code 0120 Description
https://bellmedex.com/what-is-revenue-code-0120/

PayerPrice – Revenue Code 0120 Fee Schedule
https://payerprice.com/rates/0120-RC-fee-schedule

CMS Hospital Price Transparency Resources
https://www.cms.gov/priorities/key-initiatives/hospital-price-transparency