US · guidance
CMS Pub. 100-04, ch. 25, § 70.1
Uniform Billing with Form CMS-1450
This form, also known as the UB-04, is a uniform institutional provider bill suitable for
use in billing multiple third party payers. Because it serves many payers, a particular
payer may not need some data elements. The National Uniform Billing Committee
(NUBC) maintains lists of approved coding for the form. Medicare Administrative
Contractors servicing both Part A and Part B lines of business (A/B MACs (A) and
(HHH)) responsible for receiving institutional claims also maintain lists of codes used by
Medicare. All items on Form CMS-1450 are described. The A/B MAC (A) or (HHH)
must be able to capture all NUBC-approved input data described in section 75 for audit
trail purposes and be able to pass coordination of benefits data to other payers with whom
it has a coordination of benefits agreement.
History
(Rev. 2922, Issued: 04-03-14, Effective: 04-18-14, Implementation: 04-18-14)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
55dff6e58c7b815957f3475ddf7d484d1972db5e019019aa7f7b1aecdd27f916
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