Inventory of Health Care Information Standards. HCFA Uniform Bill-92 (UB-92), Version 4.1


Contact For More Information:

Jean M. Harris - Email, 410-786-6168, FAX 410-786-4047

Description of Standard:

The UB92 consists of fixed-length (192 bytes) records. Each record has an unique identifier and logically related data elements.

Objective - The UB92 was designed to standardize and increase the submission of electronic claims and coordination of benefits exchange.

Function - The UB92 is used to electronically submit claims for health care received in an institutional setting to payers. It is also used to exchange health Care claims and payment information between payers with different payment responsibility.

User Environment - UB92 users are institutional providers. A variety of payers also use the format to exchange claim and payment information.

Systems Environment - The UB92 is a file format and is platform/operating system independent.

Application Function/Domain Completeness - All codes used in the UB92 are complete.

The UB92 is "user friendly" and easily implemented. It contains detailed record and data descriptions as well as unambiguous data definitions. It is widely used by providers of health care and payers. It is conservatively estimated that 60,000 providers use the UB92. In FY96, 141,872,119 Medicare institutional claims were submitted electronically. Ninety six point eight (96.8) percent of those claims were in the UB92. The UB92 does not have to be translated prior to application processing. The use of compression techniques eliminates at least 50% overhead when transmitting the UB92. With compression, the UB92 is more economical than an ANSI X12 837 to transport.

Readiness of Standard:

A. The UB92 is a guideline for building electronic claims. The UB92 supports policy requirements for users. The UB92 defines processes using procedure statements.

B. The UB92 was fully implemented for Medicare in 1993 (the UB83 was implemented in 1983) and continues to be supported. The UB92 has been implemented by about 73 other major payers.

C. The UB92 is available on the HCFA BPO bulletin board 410-786-0215. The file name is UB92BBS.EXE and is located in area 3. There are no restrictions and it is free of charge.

D. The UB92 implementation guide is built into the specifications, and people may build standard claims from it.

E. Some payers provide a guide to identify payer specific requirements.

F. The UB92 specifies conformity. Because it is in the public domain some people choose not to conform. This would easily be fixed if it was recognized by Federal statute. The specifications are clear and conformity is easy to achieve.

G &

H. HCFA's Office of Analysis and Systems has developed a software conformance/enforcement tool for the UB92.

I thru

M. The UB92 has been available since 1993.

Indicator of Market Acceptance:

A. Medicare implemented the standard (UB83) in 1983. Copies of the UB92 are requested frequently. The UB92 is available on a bulletin board. Diskettes were previously distributed. Since the UB92 is free of charge, the number of copies distributed is not maintained.

B. The following government agencies have implemented the UB92:

  • Medicare
  • Medicaid

Numerous Blue Cross plans use the UB92. Approximately, 73 other payers have implemented the standard.

C. We are not aware of other countries that implemented the UB92.

D. We constantly receive praise from software vendors, clearinghouses and health care providers regarding the usefulness of the UB92 and ease of implementation.

Level of Specificity:

A. The UB92 is very detailed. Record descriptions exist, as well as unambiguous data element definitions and format descriptions.

B. The UB92 framework is detailed down to the smallest named unit of information.

C. The UB92 does not reference or assume other standards to achieve more specificity.

D thru

H. The UB92 includes a code set for the patient status, accommodation revenue codes, ancillary revenue codes, and condition codes. The UB92 assumes the following code sets:



Health Care Procedure Codes (HCPCS)


ICD-9 CM Procedure Codes

National Center for Health Statistics

CPT Codes


Physicians Current Procedure Terminology Manual


Claim Adjustment Reason Code

BCBS Association

Medicare Inpatient/Outpatient Message


Investigation Device Exemption Number


Revenue, Value and Occurrence Codes

National Uniform Billing Committee

Relationship with Other Standards:

A. The ANSI X12 837 health care claim is not suitable for use in an application program and must be translated into the UB92 prior to claims processing. The UB92 does not have to be translated and, in turn, reduces administrative costs.

Identifiable Costs:

The UB92 is distributed free of charge. Typically, it takes one year from statement of intent for the UB92 to be in full production. Implementation costs vary depending on how a payer implements the standard. If a complete system rewrite is performed, the cost could be $1,000,000. If the change is at the interface, the cost could be as little as $100,000. These costs include comprehensive systems testing.