UB04 Field 48: Non-Covered Charges

Overview

Field 48 (Non-Covered Charges) is a required data element on the UB‑04 claim form, according to both CMS manuals ^{[1] [2]}. The field must contain the total non‑covered charges that are linked to the revenue code reported in Field 42 (Revenue Code) ^[1]. While the Maryland Medicaid UB‑04 instructions list Field 48 simply as “Non-Covered Charges” without further detail, they confirm its placement on the form ^[3]. The field is not separately identified as required or optional in the Maryland document, but the CMS sources mandate its completion when non‑covered charges exist ^{[1] [2]}. Because Field 48 is paired with Field 42, it provides a clear audit trail of which charge lines include amounts that the payer will not reimburse. Failing to report non‑covered charges in this field can lead to claim rejection or delayed payment.

When to Use

Field 48 is used whenever a billed service line (identified by its revenue code in Field 42) includes charges that the payer considers non‑covered ^[1]. The field is mandatory per CMS instructions ^[2]. “Non‑covered charges” refer to amounts for which the payer will provide no reimbursement, such as services excluded by the patient’s benefit plan or by statutory limitations. Even if the entire line is non‑covered, the full amount must be entered in Field 48 ^[1]. If a revenue code line has no non‑covered portion, the field may be left blank or zero, depending on payer requirements; however, CMS states the field is required, implying it should always be populated when applicable ^{[1] [2]}. Providers should verify payer‑specific guidance because some payers may require a zero or “0.00” even when no non‑covered charges exist. Maryland Medicaid does not add additional conditions beyond the field’s name ^[3]. In summary, use Field 48 whenever a service line on the UB‑04 carries any charge that will not be reimbursed by the payer.

Step-by-Step Claim Example

Therefore, on the line with revenue code 0250, the provider enters $350.00 in Field 48. If the entire charge for a revenue code is non‑covered, Field 48 would equal Field 47 for that line. For a line where the service is fully covered, Field 48 may be left blank or zero, depending on payer rules. CMS does not specify a format for zero values, but the field is required when any non‑covered amount exists ^[2]. Maryland Medicaid’s example does not provide a sample value ^[3]. After completing the line, the claim is sent to the payer, who uses the Field 48 amount to calculate what will not be reimbursed.

Common Mistakes & Audit Red Flags

A common mistake is leaving Field 48 blank when non‑covered charges are present, which contradicts CMS requirements ^{[1] [2]}. Another error is entering the non‑covered amount for the wrong revenue line; Field 48 must correspond specifically to the revenue code in Field 42 on the same claim line ^[1]. Some providers mistakenly report the total charges in Field 48 rather than only the non‑covered portion. Auditors may also flag claims where Field 48 contains an amount greater than Field 47 (Total Charges), which is impossible under the definition. Additionally, inconsistencies between Fields 47 and 48 across revenue lines can indicate miscoding. For example, if a revenue line shows $0 in Field 48 but the payer’s policy requires a split for a partially non‑covered service, the claim may be pended for review. While the provided sources do not list specific audit flags, the CMS requirement that the field is “required” makes its absence a clear deficiency ^[2]. Providers should ensure that non‑covered charges are calculated accurately and tied to the correct revenue code. Regular reconciliation of Field 48 against internal charge data can prevent denials.

Related Codes/Fields

The following table summarizes the relationship between Field 48 and key companion fields on the UB‑04, based on the provided sources.

Field / Code	Name	Relationship to Field 48	Source
FL 42	Revenue Code	Field 48 reports the non‑covered portion of the charges for the revenue code entered in FL 42.	[1]
FL 47	Total Charges	The total charges for the revenue line; the non‑covered amount in FL 48 cannot exceed this value.	[1]
FL 44	HCPCS/Rates/HIPPS Rate Codes	HCPCS codes may define the specific service; the non‑covered charge in FL 48 applies to the service identified by the HCPCS on that revenue line.	[3]
FL 46	Units of Service	The number of units is needed to verify per‑unit non‑covered amounts; FL 48 is the total non‑covered charge, not per‑unit.	[3]

These fields work together to ensure that the payer can identify which portion of the billed amount will not be reimbursed. Accurate completion of Field 48 relies on correct data in Fields 42,

---

References

[1] CMS Ch25 FL48 — https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/clm104c25.pdf

[2] CMS R1915CP — https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R1915CP.pdf

[3] Maryland Medicaid FL48 — https://health.maryland.gov/mmcp/provider/Documents/ffs-billing/UB04-Hospital-Billing-Instructions%20%281%29.pdf