Pennsylvania Code
Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 54 Pa.B. 5598 (August 31, 2024).

31 Pa. Code § 150.1. HCFA 1500 and UB 82 Health Insurance Claim Forms.

§ 150.1. HCFA 1500 and UB 82 Health Insurance Claim Forms.

 Article XII of The Insurance Company Law of 1921 (40 P. S. § §  991.1201—991.1205) directs the Insurance Department to develop a uniform health insurance claim form. Effective November 1, 1993, the Department of Public Welfare’s health care coverage program and all insurers, as defined in section 1201 of The Insurance Company Law of 1921 (40 P. S. §  992.1201), shall accept from Pennsylvania health care providers the HCFA 1500 and UB 82 forms, or their successors, as required for use in the Federal Medicare Program, for services performed in this Commonwealth for which providers are required to submit a claim form for reimbursement.


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