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Medical Billing Glossary

UB-04

The standard claim format for facility (institutional) services such as hospitals.

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Definition

The UB-04 (also called the CMS-1450) is the standard claim form for institutional providers — hospitals, facilities, and similar entities. Its electronic equivalent is the 837I transaction.

It captures facility-specific information such as revenue codes, occurrence and value codes, and other details that a professional claim does not use. Facility billing follows different rules from professional billing, and the UB-04 reflects that.

Why it matters for billing

Using the correct claim type is basic to getting paid: facility charges belong on the UB-04, professional charges on the CMS-1500. Sending the wrong form or mixing facility and professional data leads to rejections and rework.

Related terms

Terms that come up alongside UB-04 in the revenue cycle.

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EnVisionMD RCM handles eligibility, coding, documentation, denials and follow-up end to end — so the details behind terms like this one are managed for you, not left to chance.

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UB-04 — frequently asked questions

Who uses the UB-04?

Institutional providers such as hospitals and facilities; its electronic equivalent is the 837I transaction.

What is another name for the UB-04?

It is also referred to as the CMS-1450.

Authoritative References

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