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December 2016 Texas Medicaid Provider Procedures Manual

Section 6: Claims Filing : 6.6 UB-04 CMS-1450 Paper Claim Filing Instructions

The following provider types may bill electronically or use the UB-04 CMS-1450 paper claim form when requesting payment:
Note: Must use CMS‑1500 when billing THSteps.
Note: Must use CMS‑1500 when billing THSteps.
If a service is rendered in the facility setting but the facility’s medical record does not clearly support the information submitted on the facility claim, the facility may request additional information from the physician before submitting the claim to ensure the facility medical record supports the filed claim.

Texas Medicaid & Healthcare Partnership
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