tci Part B Insider - 2014 Issue 24

Reader Question: Identify the Correct Form

Question: I used to bill for a facility and am new to the role of practice manager on the physician side. Can you explain to me when a practice would use the CMS-1500 form instead of the UB-04? Answer: As a private practice, you shouldn’t need to use the UB-04 form. The definitions of the UB-04 and CMS-1500 are as follows: CMS -1500: The Form CMS-1500 is the standard paper claim form used by health care professionals and suppliers to bill Medicare Carriers or Part A/B and Durable Medical Equipment Medicare Administrative Contractors. Claims must be submitted within...

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