Billing Codes for PBF

The PBF (DCC-97) form has two types of schedules; the regular schedule and the flexible schedule.  Pay close attention when completing the PBF so that there is no delay in payment.

Regular Schedule

• The regular schedule has preprinted scheduled days underneath the day of the month.  These scheduled days are coded 01 for full day and 02 for part day.
• For a regular schedule you will only enter codes for days that are different than the preprinted schedule.
• You must enter codes for absences, terminations, holidays, full day or part day, or additional days attended. For codes, see monthly provider PBF cover letter.
• If the child did not attend, you must enter a code for an absence or no payment expected.

Flexible Schedule

• The flexible schedule will have FS preprinted in the schedule line of the PBF underneath the day of the month.  For these schedules only, you will need to write in the days that the child attends by using 01 for full day and 02 for part day.
• If you leave the schedule blank, billing staff will consider these days that the child did not attend and you will not be paid for that child.
• The PBF will tell you the maximum number of full days and part-days for which that the child is eligible.
• The cover letter that comes with each PBF provides flexible codes for licensed and certified providers to bill flexible absences and flexible holidays.  Codes for flexible schedule absences or holidays must be three digit codes to designate if it is a full day or part day absence or a full day or part day holiday.
• If a child did NOT attend certain days on a flexible schedule and you do NOT expect payment, no code is necessary.

Once the provider has determined whether a regular schedule or a flexible schedule applies for the child’s attendance, provider must determine if any of the codes below should be entered on the PBF.

Attendance Codes

Below the dates for the month, there are two lines on the PBF for each child.  The first line displays the expected attendance schedule for a child while the second line displays blank boxes where exceptions in the child’s attendance should be written.  Exceptions are changes from the expected schedule.  If a child’s attendance is different from the expected schedule, the provider must enter exception codes.

 NOTE: Codes 43, 45 and 55 are based on the provider’s circumstance.  Codes 40, 45 and 50 are based on the circumstance of the child.

The exception codes for each provider type are as follows:

Licensed Providers

Use the following codes for regular schedules:

01-	full day
02-	part day
40-	excused absence(five (5) per month permitted without documentation of the reason) NOTE:  This code is only used for the purpose of the child being absent from the center on a day that the center was open and the child was scheduled to be in attendance.  It is not used if the provider was not open for business.
43-	holiday, closed but payment requested  NOTE:  Limit of ten (10) per year.  If provider is closed for holidays for more than ten (10) days per year, they must be shown as code 55.
45-	extraordinary absence  (For absences which exceed five (5) days, written documentation of illness, (except for maternity leave), natural disaster, or death in the family must be on file and retained with the provider’s daily attendance sign-in sheets)
50-	unexcused absence – any absence which exceeds five (5) per month and is not documented by one of the four (4) reasons shown for code 45
55-	closed, no payment requested
60-	last day attended -payable day

  Use the following codes for flexible schedules:

401-	flex excused absence (five (5) per month permitted) full day
402-	flex excused absence (five (5) per month permitted) part day
431-	flex closed but payment requested (scheduled holiday) full day
432-	flex closed but payment requested (scheduled holiday) part day
451-	flex extraordinary absence full day
452-	flex extraordinary absence part day
601-	flex last day attended-payable full day
602-	flex last day attended-payable part day

Certified Providers

Use the following codes for regular schedules:

01-	full day
02-	part day
40-	excused absence (five (5) per month permitted without documentation of the reason)  NOTE: This code is only used for the purpose of the child being absent from the site on a day that the site was open and the child was scheduled to be in attendance.  It is not used if the provider was not open for business.
43-	holiday, closed but payment requested  NOTE: Limit of ten (10) per year.  If provider is closed for holidays more than ten (10) days per year, they must be shown as code 55
50-	unexcused absence-any absence in excess of five (5) per month
55-	closed, no payment requested
60-	last day attended-payable day

Use the following codes for flexible schedules:

401-	flex excused absence (five (5) per month permitted) full day
402-	flex excused absence (five (5) per month permitted) part day
431-	flex closed but payment requested (scheduled holiday) full day
432-	flex closed bu payment requested (scheduled holiday) part day
601-	flex last day attended-payable full day
602-	flex last day attended-payable part day

Registered Providers

Use the following codes:

01-	full day
02-	part day
50-	absence
60-	last day attended-payable day
601-	flex last day attended-payable full day
602-	flex last day attended-payable part day

Please feel free to contact Customer Service at 502 589-7251 if you have questions about how to complete your PBF.