B1Condition CodeSpecial Program
The beneficiary is ineligible for the full demonstration program benefits.
Related Special Program codes
90This claim reflects services approved under an Expanded Access program.91This claim reflects services provided under an Emergency Use Authorization.92This claim is for an Intensive Outpatient Program.A0This claim is submitted under a TRICARE external partnership program.A1This claim is for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services.A2This claim is funded under a Title VII handicapped services program.A3This claim uses special federal funding.A4This claim is for family planning services.A5This claim is for disability-related services.A6This claim is for a pneumococcal or influenza vaccine, covered at 100% with no patient cost-sharing.
Frequently asked questions
What does condition code B1 mean?
The beneficiary is ineligible for the full demonstration program benefits.
What category is condition code B1 in?
B1 falls under the Special Program category of UB-04 condition codes.
Descriptions sourced from CMS Medicare Claims Processing Manual. Always verify codes with authoritative sources before making billing decisions.