The fundamental distinction between the two is who uses them: medical facilities (UB-92) against independent practitioners (HCFA-1500). Medical institutions, including hospitals, nursing homes, and other facility providers, utilise the UB-92 medical claim form. Individual physicians, nurses, and therapists, for instance, use the HCFA-1500 medical claim form.
In 2005, the National Uniform Billing Committee ruled that the UB-92 form was to be replaced by the UB-04 form. The NUBC, a voluntary committee that acquires and develops data for claims and related transactions, maintains the UB form.
The fundamental distinction between the UB and HCFA-1500 forms is that the UB form is obligatory for facility billing. Institutions such as acute care facilities, stand-alone clinics, surgery centres, sub-acute facilities, home health care agencies, hospice organisations, and psychiatric, drug and alcohol treatment centres submit the form. The UB is a claim for reimbursement of inpatient and outpatient Medicare Part A services to Medicare MACs and FIs. The UB form is not used to submit costs for specific physicians or medical providers. On the HCFA-1500 claim form, these expenses are billed.
The HCFA-1500 is the standard paper claim form utilised by medical suppliers and professionals to bill Medicare providers and Medicare Administrative Contractors for Durable Medical Equipment. The HCFA-1500 must be submitted within one year of the service date, and beneficiaries cannot be charged for submitting or completing this claim.