Setting Up Fees for Use on UB04 Forms

• Every time you enter a procedure code to the fee schedule, at the bottom of the page enter the Revenue Code, Revenue Code Unids and Revenue Code Rate
• This information will show up on forms with the UB-04 submission method.

• The first step would be to add the code to the fee schedule for the Payor. Add the code in Proc code field and then scroll down to add it in UB-04 field also.
• Then go to the form and add the billing code for the particular form.

• Also, in the payor section add the the UB-04 instutional code.
• UB-04 form will require a bill type code (which is mostly a 3 digit number).