Author Topic: UB-04 versus CMS 1500  (Read 1525 times)

lgrone

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UB-04 versus CMS 1500
« on: November 04, 2015, 11:17:23 AM »
I'm hoping someone can shed some light on a question.  I'm trying to do some research for a potential new client.  They are licensed as an Outpatient Treatment Center and employ counselors.
Is all the billing to be done on a UB or would the counseling services be billed on a CMS 1500.  In the past I've only billed counseling services done in a office, on a CMS 1500.  I've gotten conflicting information when I've called the insurance companies.Any help would be greatly appreciated.

PMRNC

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Re: UB-04 versus CMS 1500
« Reply #1 on: November 04, 2015, 12:12:56 PM »
The professional component and services are billed on the CMS-1500
The facility charges are billed on the UB..

Not sure why you would get different information it's universal.
Linda Walker
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Michele

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Re: UB-04 versus CMS 1500
« Reply #2 on: November 04, 2015, 03:59:57 PM »
We actually billed for an outpatient drug and alcohol rehab facility that was an approved OASIS facility.  The counseling sessions for some insurance carriers had to be billed on UB04 forms.  BCBS in particular would not pay any of their services if billed on a CMS 1500 form.  But other insurance carriers required the sessions be billed on the CMS form. 
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lgrone

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Re: UB-04 versus CMS 1500
« Reply #3 on: November 05, 2015, 09:28:27 AM »
Thanks for the responses.  It was reassuring to hear that different payers are requiring different things.  That's what I was finding and was confused by that.  I had thought it was more universal.