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Who uses UB04 form?

The UB-04 (CMS 1450) is a claim form used by hospitals, nursing facilities, in-patient, and other facility providers. A specific facility provider of service may also utilize this type of form.

Where is UB04 form used?

The UB-04 (CMS-1450) form is the claim form for institutional facilities such as hospitals or outpatient facilities. This would include things like surgery, radiology, laboratory, or other facility services.

How do I get a UB-04?

UB-04 instructions and forms can be downloaded free of charge from the Web site for the Centers for Medicare and Medicaid Services (CMS) at http://www.cms.hhs.gov/transmittals/downloads/R1104CP.pdf. UB-04 manuals may be ordered from the National Uniform Billing Committee Web site at http://www.nubc.org/.

What was a UB40 form?

The name "UB40" was selected in reference to an attendance card issued to people claiming unemployment benefits from the UK government Department of Employment. The designation UB40 stood for Unemployment Benefit, Form 40.

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