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UB-04 Licensing

Rely on the Official Source

The NUBC was formed in 1975 to develop and maintain a single billing form and standard data set to be used nationwide by institutional, private and public providers and payers for handling health care claims. The AHA develops, publishes and holds the copyright to the UB-04 Manual.

Official UB-04 Electronic Data Set
Created by the American Hospital Association in partnership with the National Uniform Billing Committee.

The Official UB-04 Electronic Data Set provides updated specifications of the data elements (codes) included on the UB-04 (Uniform Bill) claim form. Data specifications are an integral part of the HIPAA transaction standard for electronic claims submission. Providers and payers alike use the manual to determine the appropriate codes for sending and receiving claims. This new electronic format will allow organizations to incorporate the codes into currently used information systems.

UB-04 Electronic Data Set includes:

  • All billing conventions and codes
  • Field attributes
  • Form locators
  • Approval and effective dates
  • Data element descriptions
  • Revenue
  • Definitions
  • Condition
  • Reporting requirements
  • Occurrence and value codes

Internal Use License includes:

  • Complete UB-04 Electronic Data Set in an electronic format
  • Incorporation into an internal information system for internal use only —may not be forwarded nor used by other individuals outside the organization.
  • Access to protected NUBC minutes archive

This license does not include distribution outside the hospital, health plan or other organizations.

Distribution License includes:

  • Non-exclusive right to use the UB-04 Electronic Data Set in content-added products that may be distributed externally
  • Access to protected NUBC minutes archive

Please email ub04@healthforum.com for more information.