Question: Under which circumstance can a freestanding ASC use both the UB-04 and CMS-1500 claim forms for the same patient?
Answer: Freestanding ASCs typically report services globally on the CMS-1500. However, you may need to use both forms, depending upon payer requirements. Hospital-based ASCs generally use the UB-04 form for facility charges and the CMS-1500 form for the professional charges of the physician, but again check payer guidance.
The definitions of the UB-04 and CMS-1500 are as follows:
Professional providers should generally submit claims using the CMS-1500 forms and institutional providers should submit claims using the UB-04.