UB-04 Claim Form Practice Test 2026 – Comprehensive Exam Prep

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UB-04 claim form is also known as CMS-1450. Which CMS form name corresponds to this form?

CMS-1450

The UB-04 is the standard institutional claim form used for hospital and facility billing, and its official CMS form name is CMS-1450. This designation comes from CMS, where CMS-1450 identifies the form used to submit facility charges. The other names refer to different things: CMS-1500 is the professional claim form used by physicians and non-institutional providers; ICD-10-PCS is the inpatient procedure coding system; NUBC is the committee that standardizes billing data and forms, not a specific form. So the form name that matches UB-04 is CMS-1450.

CMS-1500

ICD-10-PCS

NUBC

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