Rhode Island Department of Human Services

Especially For:

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Revenue Codes

Respite Care

Revenue Code Description
660 Respite care
661 Hourly charge/skilled nursing
662 Hourly charge/home health aid/homemaker

Outpatient Services

Revenue Code Description
500 Outpatient services (crossover only)
509 Other outpatient

Clinic

Revenue Code Description
510 Clinic
511 Chronic pain
512 Dental
513 Psychiatric
514 OB-GYN
515 Pediatric
519 Other
520 Freestanding clinic
521 Rural health - clinic
522 Rural health - home
523 Family practice
529 Other freestanding clinic

Osteopathic Service

Revenue Code Description
530 Osteopathic services
531 Osteopathic therapy
539 Other osteopathic

Medical Social Service

Revenue Code Description
560 Medical social service
561 Visit charge
562 Hourly charge
590 Other medical social services

MRI

Revenue Code Description
610 MRI
611 Brain (including brain stem)
612 Spinal cord (including spine)
619 Other MRI

Medical/Surgical Supplies - Extension of 27x

Revenue Code Description
621 Supplies incident to radiology
622 Supplies incident to other diagnostic services

Drugs Requiring Specific Identification

Revenue Code Description
630 Drugs
631 Single source drug
632 Multiple source drug
633 Restrictive prescription
634 Erythropoietin (EPO) less than 10000 units
635 Erythropoietin (EPO) 10000 or more units
636 Drugs requiring detailed coding*

Note: Revenue code 636 relates to HCPCS code, so HCPCS is the recommended code to be used in form locator 44. The specified units of service to be reported should be in hundreds (100s), rounded to the nearest hundred (no decimal).