How are coinsurance and deductible handled on UB-04?

• A. As patient responsibility amounts reported via value codes or line-level fields per payer rules
• B. They are ignored
• C. They are charged to the physician
• D. They are included in marketing materials

Answer: (A)

Coinsurance and deductible are patient responsibility amounts that must be shown on the UB‑04 to reflect what the patient owes after the insurer pays. These amounts are communicated on the claim using the payer’s required method, typically through value codes or by placing the amounts in line‑level fields tied to each service. This standardized reporting makes sure the payer sees the correct patient portion and that the patient balance is accurately reflected on statements. It also helps with proper adjudication and posting of payments.

These amounts are not ignored, they are not charged to the physician, and they are not used in marketing materials. They exist to accurately capture the patient’s financial responsibility in the claim data per payer rules.