Reminder: Changes in definitions for value codes Y1 through Y5

The National Uniform Billing Committee wants to remind you about the following changes to the definitions of value codes Y1 through Y5. These changes were made April 1, 2013.

Y1– Part A Demonstration: This is the portion of the payment designated as reimbursement for Medicare Part A services under the demonstration model claim. 

Y2 – Part B Demonstration Payment: This is the portion of the payment designated as reimbursement for Medicare Part B services under the demonstration model claim. No deductible or coinsurance has been applied.

Y3 – Part B Coinsurance: This is the amount of Medicare Part B coinsurance applied by Medicare Part A & B Medicare Administrative Contractors to this demonstration model claim.

Y4 – Conventional Provider Payment: This is the amount Medicare would have reimbursed the provider for Part A services if there had been no demonstration model claim.

Y5 – Part B Deductible: This code was added April 1, 2013, as part of BCBSM’s billing guidelines. This code indicates the amount of Part B deductible applied by administrative contractors to this demonstration model claim.

Value codes are reported in form locator 39-41 of the UB-04 Claim Form. For information about completing any of the locators on the claim form, refer to your UB-04 Manual.