Properly using revenue code 0114 is vital when it comes to billing in psychiatric and behavioral health. When the code on your UB-04 aligns with the inpatient mental health services you actually provided, your claims are able to flow through the insurance review process with more efficiency. This lessens your likelihood of contacting a payer multiple times about the service reimbursement, having to follow up about previously submitted claims, and going through unnecessary delays, all of which could slow down payment for psychiatric room and board.
This guide will detail how 0114 is utilized in behavioral health claims, when 0114 is applicable to inpatient psychiatric care, and how to properly bill for it which will reduce unnecessary barriers to receiving reimbursement for your behavioral health services.
What is Revenue Code 0114 in Medical Billing?
Revenue code 0114 is the code you will use when an inpatient stays in a private room for psychiatric care. The psychiatric care can be defined as any psychiatric activity like a comprehensive inpatient psychiatric assessment, psychotropic medication reevaluation, daily nursing care and safety checks, individual or group therapy, crisis stabilization, or one to one observation, depending on the treatment plan.
Think of RC 0114 as a tag that tells the payer what you’re billing for.
Here is the simple breakdown:
- Revenue codes are four digits on a UB-04 hospital billing claim form.
- The first three digits, 011, are for a private room and board.
- The last digit, 4, tells the payer it’s for psychiatric services.
When you use 0114, it signals “This patient received inpatient psychiatric service, in a private room.” Using the appropriate revenue code provides your claim a match to the services, ensuring less inquiries and less lag time on reimbursement by the payer.
That is all 0114 is. A clear signal of private room and board services for inpatient psychiatric services.
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The Usage of Revenue Code 0114
Knowing what 0114 means is helpful, but the real win is knowing when to put it on a claim.
Use revenue code 0114 when all of the following are true:
✅ The patient is an inpatient on a psychiatric unit or in a free standing psychiatric hospital.
✅ You are billing room and board for a private room.
✅ Care involves 24 hour supervision in a structured setting for safety and stabilization.
Quick Example:
A 35 year old is admitted to an inpatient psych unit. Over a 5 day stay they receive nursing care around the clock, medication management, and therapy. You would bill 0114 for each day the patient is in a private room on that psych unit.
About other services: therapies, testing, and medications may or may not be billed separately. It depends on the payer and setting. Some payers bundle many services into the inpatient per diem, while others allow separate line items. Check the payer policy before listing them out.
If the room is not private, use the matching psych room and board code instead, such as 0124 for semiprivate two bed or 0134 for semiprivate more than two.
When not to use this code:
❌ Outpatient therapy visits
❌ Partial hospitalization programs
❌ Intensive outpatient programs
❌ A patient on a medical or surgical floor who only receives a psych consult
❌ A specific therapy or procedure by itself, since those have their own codes when billable
Some Important Things To Keep In Mind:
- 0114 is only for inpatient psychiatric room and board in a private room. Use the code that matches the setting and the actual room type, and you will avoid preventable denials.
- Bill one unit of 0114 for each midnight the patient spends in a private psychiatric room.
- Count the admission day if the patient is still inpatient at midnight. The discharge day is usually not billed for room and board.
- If the patient changes rooms during the day, code the room they are in at the midnight census. For example, if they end up in a semiprivate psych room at midnight, use 0124 for that day.
- If they transfer to another unit or facility before midnight, that location bills for that date of service.
Reimbursement Rates for Revenue Code 0114
Some websites show average reimbursement rates for inpatient psychiatric private rooms under revenue code 0114. For example, PayPrice reports daily rates as follows:
- Blue Cross Blue Shield: about $2,201 per day.
- UnitedHealthcare: about $1,549 per day.
- Aetna: about $2,104 per day.
- Cigna: about $1,385 per day.
These reimbursement rates provide a starting place, but keep in mind the revenue code isn’t the payment. Revenue code 0114 only represents the service. The payment you receive is determined by the payer’s pricing method and your contract’s terms with that payer.
There is no national reimbursement rate for Revenue Code 0114. What you find on aggregator websites will not be accurate to your contract terms or the terms of Medicare, perhaps leading you to think this is your reimbursement. Therefore, always refer back to your contract, the payer’s fee schedule, or your hospital’s posted payer-specific files.
The largest influence on the payment for Revenue Code 0114 is typically:
👉 Your contract, and the payer. Commercial insurers often will allow a set daily rate, called a per diem, for inpatient psych. Payment for out-of-network claims may be priced differently. By law, hospitals also have to post their payer-specific negotiated rates.
👉 Medicare rules. Medicare categorized billing based on the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS). It pays a base daily rate, adjusted by year. If a Medicare beneficiary patient stays one day, Medicare would simply pay the daily base rate. Imbalance of each day of stay and additional factors would modify the base daily per diem. For Medicare, the other factors include day of stay, age of patient, conditions of the patient, ECT, rural area, whether the hospital trains residents, and local wage index. For 2025, the stated base per diem is $876.53 not taking into account the modifications or adjustments.
👉 The setting. For Medicare patients, there are special rules for freestanding psychiatric hospitals, including a 190-day lifetime limit that does not apply to psych units within general hospitals.
How to find your true reimbursement rate:
- Review the patient’s plan and your contract for the daily inpatient psych terms.
- For Medicare patients, review the current IPF PPS, along with the adjustments, and apply adjustments for each factor that applies.
- Finally, you can review your hospital’s price transparency file to find the payer-specific negotiated rate for inpatient psychiatric treatment per day.
How to Bill Revenue Code 0114 in Healthcare Settings?
When you bill revenue code 0114, you are just going through a regular process of: confirming coverage, filling out the claim form, putting documentation with it, and then submitting it for billing.
1). Confirm coverage first
Before admitting the patient, always verify that the insurance covers inpatient psychiatric care. This means you have confirmed that your plan allows this level of care, pre-authorization is acquired if needed, and length of stay doesn’t have limits associated with it. Also confirm your facility is an in-network facility. Confirming these at the beginning avoids all of the claim denials, and headache of providing care that is uncovered.
2). Put 0114 on the UB 04 form correctly
Once patient admission has taken place, you will then use the UB 04 claim form for billing:
- In the revenue code field (FL 42), enter 0114.
- Then, in the service units field (FL 46), list the number of inpatient days.
- In the total charges field (FL 47), put the daily rate multiplied by those days.
Most hospitals put down one line with multiple days, rather than individual lines with each day. If the patient is still inpatient at midnight, you would count them as an admission day. The discharge day is not generally billed for room and board. If the room type is adjusted during day, the room the patient is in as of midnight will be billed.
3). Make sure your notes justify the stay
Insurance payors will look very carefully at the chart to see if inpatient care was clinical warranted. Hence, your notes will have to create the depiction of the patient’s stay. Document reason for admission, the treatment plan, and daily progress made. Depict the need for 24 hour supervision, the capability of a structured environment, the medication management and discharge planning. Also explain why outpatient treatment would have not been enough. Payers are scrutinizing psychiatric admissions more than ever before, so a solid documentation process is your way to getting reimbursed with 0114 revenue code.
4). Know what to put with 0114 and what not to
➜ For the facility UB 04 for inpatient psych stay, 0114 typically covers room, board, and a host of therapies in a per diem environment catering to the inpatient psych special. Typically, you will not bill psychotherapy CPT codes on the inpatient facility claim unless your payer contract specifically states the the inpatient facility can bill for other professional services.
➜ Usually the psychiatrist, psychologist, or therapist will be billing their professional services on the CMS 1500 claim form using psychotherapy CPT codes such as 90832, 90834, 90837, 90853, and 90863, while designating the inpatient place of service.
➜ Use of telehealth modifiers like 95 or GT could be for their respective telehealth service when allowed. Telehealth modifiers type would not be attached to the 0114 room and board line on the facility claim.
If your payer allows certain ancillaries separately on the UB 04, use the correct revenue code for that item, and follow the payer’s policy.
5). Review and submit
Before sending the claim, double check:
- Required fields filled out.
- Revenue code and any other lines reflect the documentation.
- Units & charges calculate correctly.
- Any required authorization number is included.
- Then send to payer electronically or via paper, as needed by the payer.
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