Which UB-04 feature reports monetary values such as patient responsibility?

• A. Value Codes and Amounts
• B. Occurrence Codes
• C. Attending Physician
• D. Statement Covers Period

Answer: (A)

On UB-04, monetary values such as patient responsibility are reported using value codes and amounts. Each value code identifies a specific type of financial amount (like patient deductible, coinsurance, or copayment), and the corresponding amount field shows the dollar value for that category. This structure lets the payer see exactly how much the patient owes separate from the standard charges and payments.

Occurence codes record key dates and events, not money. Attending physician identifies the clinician, not finances. Statement covers period indicates the service timeframe, not monetary details. So the feature that captures monetary values tied to the patient’s responsibility is value codes and amounts.