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CMS700 blank fillable-1.pdf: REHAB 577 A Sp 21 - UW Canvas
clinical record number used by the billing provider. ... date matches occurrence code 11 on the UB-92. ... PT, 44 for OT, 45 for SLP and 46 for CR on the UB-92).
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Institutional paper claim form (CMS-1450)
Dec 1, 2021 — 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 ...
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