UB-04 to replace UB-92 for inpatient paper claim forms

Switch from UB-92 to UB-04 Paper Forms by May 23, 2007

The Centers for Medicare & Medicaid Services (CMS) announced that all providers who bill Medicare fiscal intermediaries, including regional home health intermediaries, using the UB-92 paper form must begin using the new paper form (UB-04) by May 23, 2007. CMS will no longer accept the UB-92, even as an adjustment claim, after May 22. Providers may begin using the new form on March 1.

The UB-04, which is only accepted from institutional providers that are excluded from the mandatory electronic claims submission requirements, incorporates the National Provider Identifier, taxonomy and additional codes. While most of the data-usage descriptions and allowable data values have not changed on the UB-04, many UB-92 data locations are different. In addition, bill-type processing will change. Providers are encouraged to ensure that their billing staffs are aware of this new, uniform, institutional provider bill form for paper claims.