The UB-92 (CMS-1450) form and instructions are used by institutional and other selected providers to complete a Medicare, Part A paper claim for submission to Medicare Fiscal Intermediaries. The paper UB-92 (Form CMS-1450) is neither a government printed form nor distributed by the CMS. The National Uniform Billing Committee is responsible for the design of the form.
To obtain a electronic copy of Form CMS-1450 (UB-92), CMS-1450 instructions, please go to:
www.mtindia.org/freedownloads/default.cfm 
