Interactive UB-04 Tool Now Available

Medicare Part A and Part B MAC for Jurisdiction 11; comprised of North Carolina, South Carolina, Virginia and West Virginia. Medicare Part A and Part B MAC for Jurisdiction 1; comprised of California, Hawaii and Nevada. The Uniform Bill (UB-04) is the standardized billing form for institutional services. Palmetto GBA is providing an ’Interactive UB-04’ self-service tool. This interactive guide provides step-by-step instructions on how to complete the UB-04 form. Included is a sample form that allows users to click on each field to view what information is entered in that field, and to decide if the field is required, not required or situational when filling out the claim.