UB-04 (aka CMS-1450) Resources
A while back, I posted a short TikTok about the differences between a 1500 and UB, and got a question about where to find a free fillable UB form.
As usual, the findings are a mixed bag, and there is no shortage of services/resources you can pay for, but I’ve collected a few that might be helpful for people looking into the UB-04 (also apparently called the CMS-1450).
Disclaimer: I am not a certified coder or billing specialist, and these links are for reference only. My use of claims/forms is typically from an analytical perspective. So while this was the most updated information and the most current links at the time of writing this post, I recommend confirming that these are the correct/most updated versions of the forms, becoming familiar with the appropriate way to use these forms when billing for services, and seeking the advice of a certified professional if you have additional questions.
The CDC posted a PDF version of the UB-04/CMS-1450) you can download, print, and use your PDF software to “fill”
CMS talks a little about the form here and states: “You can find Medicare CMS-1450 UB-04 completion and coding instructions in Chapter 25 of the Medicare Claims Processing Manual (Pub.100-04).”
The National Uniform Billing Committee (NUBC) is formally responsible for the design of the form and maintains all documentation, including a manual and resources (mostly for purchase)
You can purchase hard copy forms, including from Amazon