22-3-7.2-7. Permitted Forms

Effective 1-1-2023.

Sec. 7. A medical service provider shall submit only the following forms for payment by a payor:

(1) CMS 1450 (UB-04).

(2) CMS 1500 (HCFA-1500).

(3) American Dental Association (ADA) claim form.

As added by P.L.160-2022, SEC.10.