Setup New Service Code

Sometimes you may need to add a new service code to the system. These steps work for both billable and non-billable service codes.

The information you enter for a service code controls how services and billing work. If it is not set up correctly, billing may not process.

If you are unsure about any step, please contact the Help Desk for assistance.

Important: Before You Start

For billing to process correctly:

  1. The service must be added to the Facility Master – Fee for Service tab
  2. The service must be added to the Consumer Service Authorization tab

If these settings are not correct, billing will reject.

Step 1: Service Code Master

  1. Follow the steps in Service Code Master to create the new code.
  2. It is helpful to review an existing service code to make sure your new one is set up the same way.

Step 2: Procedure Code Master

This step is very important. If modifiers are missing, billing will reject.

  1. Follow the steps in Procedure Code Master.
  2. If the code includes modifiers (for example: W9029-U5-HI):
  3. Add the first modifier (U5) in the Price Modifier 1 field.
  4. Add the second modifier (HI) in the Info Modifier 1 field.

Step 3: Facility Master

If the new code is not listed here, you will get an error when you run billing.

  1. Make sure the new service code is listed on the: Maintain menu > Master Tables > Facility Master → Fee for Service tab
  2. Select the facility where the service will be provided.
  3. The following columns are required for billing to process properly:
    1. Service (Description will auto populate once you select a service code)
    2. Rate: Enter the correct reimbursement rate (the amount you bill).
    3. Unit Type
    4. Status
    5. Begin Date
    6. Procedure
    7. Provider #
  4. Tab to the next blank line to save.

Step 4: Consumer Service Authorization

Add the new service code to the consumer’s service authorization tab.

Follow the steps in Add a Service Plan.

Step 5: Assign Forms (If You Use Documentation)

If staff complete notes in the system, you must assign the form to the new service code.

If you do not assign a form, staff will not be able to save notes.

Follow the steps in Assign Forms.

Step 6: Review First Billing

To make sure everything is set up correctly:

  1. Run the EDI Billing Edit Error Check List before you generate the EDI billing file. If something is missing, the report will tell you what needs fixed.
  2. After you submit your first billing file, make sure to review the EDI Billing Verification - the BILLED and 277 AMOUNT should match.
  3. Make sure to review your Trade File the following week to ensure all services were paid.

2/2026

NEED MORE HELP?  Submit a ticket to the Help Desk or call (814) 535-7810 or (800) 889-3388