The CMS-1500 form is used by individual healthcare providers and practices (such as therapists, physicians, nurse practitioners, and other professional services, including dental offices billing for medical procedures) to bill insurance carriers for outpatient and professional services.
The UB-04 form (also known as CMS-1450) is used by hospitals, skilled nursing facilities, home health agencies, and other institutional providers to bill for facility-based services, such as inpatient care, outpatient hospital visits, and procedures performed in a hospital setting.
In short:
Both forms collect similar information—patient details, provider information, diagnosis, and procedures—but are structured differently to meet the needs of professional vs. institutional billing.
