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Professional Technical IVT

CMS-1450

Pronunciation: C-M-S fourteen fifty

Also written as: CMS-1450 — Centers for Medicare and Medicaid Services Form 1450

The standardised institutional claim form (also known as the UB-04) used by inpatient rehabilitation facilities and other institutional providers to bill Medicare, Medicaid, and commercial insurers for services rendered.

Full Definition

The CMS-1450, colloquially called the UB-04 (Uniform Billing form, 2004 edition), is the universal institutional billing form mandated by the Centers for Medicare and Medicaid Services for facility-based claims, including those submitted by inpatient rehabilitation facilities (IRFs), skilled nursing facilities, and hospital outpatient departments. In PM&R administrative and billing documentation, editors may encounter this form when reviewing or proofreading claim documentation, billing audits, compliance reports, or denial management correspondence. The form contains standardised data fields (condition codes, occurrence codes, revenue codes, and HCPCS/CPT procedure codes) that have precise meanings and must not be paraphrased or conflated. The current version is UB-04; the predecessor UB-92 is obsolete. Editors should render the form designation as 'CMS-1450' or 'UB-04,' not as 'UB04' or 'CMS 1450' (without hyphen).

Usage

Usage note: Always hyphenate: 'CMS-1450,' not 'CMS 1450.' Do not confuse with CMS-1500, which is the professional (physician) claim form. The common name 'UB-04' should also be hyphenated.

In Context

  • "The billing specialist submitted the CMS-1450 with condition code 61 to indicate the patient's IRF admission met medical necessity criteria." — Inpatient rehabilitation billing documentation
  • "An audit of CMS-1450 forms revealed that several revenue codes had been incorrectly entered, triggering claim rejections." — Compliance audit report

Also known as

UB-04 Uniform Billing form

Don't confuse with

CMS-1500 HCFA-1500

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