US · guidance
CMS Pub. 100-05, ch. 5, § 70.3.1
Review of Form CMS-1450
The reviewer shall obtain all Form CMS-1450s, also known as the UB-04, for each case
included in the sample. The reviewer shall separate the bills according to bill type. The
reviewer shall determine the amount billed to Medicare for each case. The reviewer shall
review Form CMS-1450 for the following MSP data to determine if the billed amount is
accurate and to conduct the comparison process using the admissions questions and
responses described at §70.5.3, Exhibit 3. Item numbers reflect Form CMS-1450 field
locators.
History
(Rev. 11550; Issued: 08-12-22; Effective: 10-13-22; Implementation:10-13-22)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
383ebbb3fc4b5f0638b77930ba9c21acc073737e94d9bf121a3a2a076ae506a9
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