Which form is used for professional claims?

• A. UB-04
• B. CMS-1500
• C. CPT-4
• D. HCPCS

Answer: (B)

Professional claims are filed on the CMS-1500 form because it is the standard form designed for non-institutional or professional services providers, such as physicians and therapists, to bill payers. This form gathers essential information like patient and provider details, dates of service, diagnosis codes (ICD-10-CM), and procedure/service codes (CPT/HCPCS), along with charges and payer information. The UB-04 form serves institutional claims (hospitals, facilities), not professional services. CPT-4 and HCPCS are coding systems used to describe procedures and services, not the actual claim form. So the CMS-1500 is the form specifically used for professional claims.