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Service Rules — Outputs

Output fields define what gets billed — CPT codes, units, modifiers, add-on codes, claim type, and more.

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Written by Bridget Cashman
Updated yesterday

Service Rules — Outputs

Outputs define what gets billed. They operate at the service level, or at the bundle level when bundling is enabled.

CPT Code

The primary output. Payers use CPT codes to determine payment. The billed dollar amount is pulled from your fee schedule at the time the service is created.

Units

  • Calculated as: encounter duration ÷ unit interval.

  • A unit interval of 0 bills 1 unit for the entire service regardless of duration.

  • A unit interval of 15 bills 1 unit per 15 minutes (e.g., a 60-minute encounter = 4 units).

  • Unit rounding options: Round to nearest (standard), always round up, or always round down.

Min/Max Units

  • Applied at the service level (or bundle level when bundling is on).

  • Minimum: if calculated units fall below the minimum, Ritten bumps up to the minimum.

  • Maximum: caps the total units billed.

  • Min/max units are separate from minimum bundled minutes — do not confuse the two.

Revenue Code

Configurable in the service rule. Appears alongside the CPT code on UB-04 claims.

Place of Service (POS)

Configurable in the service rule. Can also be driven by encounter attributes via override triggers.

Rendering Provider

Options for how the rendering provider is set: encounter creator, encounter creator's supervisor, a fixed provider for the rule, a fixed provider for the entire organization, or via the Supervising Provider feature.

Add-On Codes

  • Automatically creates an additional service line on the claim with its own CPT code and configuration.

  • Use when a secondary code must always travel with the primary code (e.g., individual therapy + additional time units).

  • Add-on codes have their own configuration: revenue code, unit interval, rounding, min/max units, and modifiers.

  • Add-on codes pull rates from the payer-specific fee schedule. If an add-on code shows $0, verify that the CPT code exists in the fee schedule for that payer.

  • There is a per-add-on setting to suppress the CPT code from Box 44 on UB-04 claims — useful when a payer only wants the revenue code on that line.

Claim Type

Set the claim form type in outputs: Professional (CMS-1500) or Institutional (UB-04). This can also be changed conditionally via an override.

Billing Provider

The organization billing for the service. Typically your facility. Can be set in outputs and changed via override.

UB-04 Type of Bill (Box 4)

  • Digits 2 and 3 of the Type of Bill can be configured as a service rule output or override.

  • Digit 4 is configured via Global Variables and applies organization-wide.

Value Codes (UB-04 Only)

Value codes appear in Boxes 39–41 on the UB-04. They have no effect on CMS-1500 claims.

Include Diagnosis Options

Configure which diagnoses to include on the claim: mental health diagnoses only, substance use disorder diagnoses only, or all diagnoses.

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