Billing Overview

FORM UB-04

The MCTAC Billing tool is an interactive UB-04 form that walks through the components required to submit a clean claim. Whether you are new to the process or just want to quickly check one field, the billing tool is the ideal reference.

This tool will tell you what information is required for each field and will note specific plan requirements. 
 

Please note this guidance only applies to Behavioral Health outpatient/ambulatory services billing Medicaid Managed Care.

Hover over or click each numbered field for more information.