Which form is used for professional services claims (physician, therapy, and other non-facility providers)?

• A. CMS-1500 form
• B. UB-04 form
• C. HCFA-1500 form
• D. UB-92 form

Answer: (A)

Professional services claims, such as those from physicians and therapists, are billed on the CMS-1500 form. This form is designed for non-facility providers and is the current standard used for professional services. It used to be known as HCFA-1500, so you may see that older material refer to it by that name, but the modern designation is CMS-1500. The other forms are for facility claims: UB-04 (and its predecessor UB-92) are used by hospitals and other facilities to bill for their services. So CMS-1500 is the correct choice for professional services.