How are hospice or long-term care services represented on UB-04?

• A. Using appropriate TOB values, service lines with correct revenue codes, and payer data reflecting the setting.
• B. Hospice is represented the same as any inpatient service; setting does not matter.
• C. Only revenue codes matter; TOB values are irrelevant.
• D. Payer data is ignored for long-term care settings.

Answer: (B)

Hospice and long‑term care billing on UB-04 is defined by the whole billing context, not just individual codes. The Type of Bill (TOB) sets the claim category and the care setting, which determines which payment rules apply. Each service line then uses revenue codes to show exactly what was provided—such as room and board, skilled nursing care, therapies, or other services. Payer data ties the claim to the correct payer and program, reflecting the setting (for example, hospice benefits or long‑term care coverage) and ensuring proper adjudication.

That combination—TOB indicating the setting, service lines with the right revenue codes, and payer information aligned to that setting—is what ensures hospice or long‑term care is represented accurately on UB‑04. Merely treating hospice as a generic inpatient service ignores the specific billing context and the rules that apply to that setting. Likewise, relying only on revenue codes omits the essential TOB and payer context that drive payment.