Ub 04 cms form 2025

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The Health Insurance Claim Form (CMS-1500) is used by Allied Health professionals, physicians, laboratories and pharmacies to bill supplies and services to the Medi-Cal program. Providers are required to purchase CMS-1500 claim forms from a vendor. Claim forms ordered through vendors must include red drop-out ink.
The 837I (Institutional) is the standard format used by institutional providers to transmit health care claims electronically. The UB-04 Form, also known as the CMS-1450, is the standard claim form to bill Medicare Administrative Contractors (MACs) when a paper claim is allowed.
So, CMS 1500 is used only by the physicians and not hospitals. Whereas UB-04 or CMS 1450 form is used by hospitals with 81 field locators to enter all the required details like HCPCS codes, NPI, Tax ID, etc.
The UB-04 claim form is used to submit claims for outpatient services by institutional facilities (for example, outpatient departments, Rural Health Clinics and chronic dialysis centers).
To reduce the administrative burden and increase provider participation, the Board will consolidate and eliminate certain medical billing forms and convert to the CMS-1500, the universal claim form used by medical providers to bill the Centers for Medicare and Medicaid Services (CMS) as well as health insurers.
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The CMS-1450 form (aka UB-04 at present) can be used by an institutional provider to bill a Medicare fiscal intermediary (FI) when a provider qualifies for a waiver from the Administrative Simplification Compliance Act (ASCA) requirement for electronic submission of claims.

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