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Effective March 1, 2007, CMS will begin accepting the new UB-04 claim form which replaces the UB-92 claim form. The UB-04 will be mandatory effective May 23, 2007.
From March 1, 2007 through May 23, 2007 providers may use either the current UB-92 claim form or the new UB-04 claim form.
We only carry the new UB-04 claim form. There are other medical supply companies that may carry the old UB-92 claim form.
SHIPPING NOTE: When ordering claim forms, select Zone Rate when checking out. If you forget, your shipping charge will be adjusted before your order is shipped.
Weight: 6 lb
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