What's The Difference Between CMS-1500 and UB-04 or CMS-1450

by Debbie
(Logan WV)

This site sure has helped me out alot to answering my questions. I am just getting into medical billing and coding, this is a life saver. Just wanted to say "THANK YOU".

Thanks for visiting the site - glad it's helped you.

The CMS-1500 form is the health insurance claim form used for submitting physician and professional claims providers.

The CMS-1450 (UB-04) form is the claim form for facilities such as hospitals or outpatient facilities.

The Centers for Medicare and Medicaid Services is the government entity which mandates use of these forms.

(Updated 7/2016 - Corrected. Sorry for the confusion but my original answer was too vague)


Comments for What's The Difference Between CMS-1500 and UB-04 or CMS-1450

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Jul 11, 2016
Different use of claims forms
by: Anonymous

1500 is a professional form used by physicians and specialist not facilities (hospitals). UB04 is for Facility hospitals whether it is IP or OP. Facilities can not file Hospital charges on 1500 only professional fees can be filed.

May 24, 2016
by: Anonymous


Feb 25, 2016
Billing Consultant
by: Anonymous

This is wrong; it is the opposite. Please check your resources. 1500 is for inpatient/professionals; UB04 is for outpatient/facilities i.e. outpatient therapy or home health, etc. There is nothing more frustrating as a biller than insurance companies and individuals getting the two confused.

Jan 12, 2016
The difference between CMS-1500 and UB-04
by: Patricia

Thank you for the information.

Mar 11, 2015
going further
by: Anonymous

UB-04 claim for is for inpatient stay greater than 24 hours in a medical facility. And CMS-1500 is for outpatient visits that are same day discharge or less than 24 hours. CMS-1450 is sometimes another term for UB-04 claim form.

Feb 12, 2015
This information is wrong.
by: Nikki

CMS prefers that you submit all claims to Medicare electronically.


Jan 14, 2015
CSM-1500 and UB-04
by: Anonymous

Thank you for your information, it was great help.

May 24, 2014
by: Anonymous

Thanks for all your information an all but it would have helped more if you could have gave some more on the differences between the two (CMS-1500, and UB-1450) but thanks anyway I use this site a lot and usually it helps a lot I try to use it in all of my medical billing and coding questions so thank you very much.

Feb 27, 2014
Claim form UB-04
by: Jacob Marcus

Claim form UB-04 is one of the very important claim forms required to be filled up by medical service providers for reimbursement of medical expenses.

Jun 12, 2012
for the info
by: Anonymous

Thank U

Mar 02, 2012
Claim form Difference
by: Robin

Thank you! Your information was great.

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