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First Coast Service Options Inc.
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Last Modified: 7/28/2010 Location: FL, PR, USVI Business: Part A

CMS-1500/UB-04 form inquiry

Do you have questions on how to complete the UB-04 (uniform billing), also known as CMS-1450, claim form?
• We recommend you review the instructions outlined in the Centers for Medicare & Medicaid Services (CMS) Internet-only manuals (IOM), publication 100-04, chapter 25-Completing and processing the form CMS-1450 external link to pdf data set to make sure you're completing the required fields within your claims.
• CMS also makes available a UB-04 Web-based training course at http://www.cms.hhs.gov/MLNGenInfo/ external link.
For information on the CMS-1500 claim form, click here.
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Source: FCSO Education Action Team
First Coast Service Options (FCSO) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.