Which form is used for institutional claims in typical health care billing?

• A. CMS-1500
• B. UB-04
• C. CPT form
• D. ICD-10-CM form

Answer: (B)

Institutional claims come from facilities such as hospitals and need a form that can capture multiple line items tied to facility charges, like room and board, supplies, and services across a patient stay. The form designed for this purpose is the UB-04 (CMS-1450). It supports field-heavy, line-item billing organized by revenue codes and includes details such as admission and discharge dates, type of bill, and facility-specific charges, which is why it’s the standard for institutional claims.

The other options don’t fit institutional billing. The CMS-1500 is for professional services billed by individual clinicians (physician, clinic encounters). CPT codes describe procedures and services but aren’t themselves a claim form. ICD-10-CM codes describe diagnoses, not the claim form.