UB04 Field 6: Statement Covers Period

Overview

Field 6: Statement Covers Period is a mandatory field on the UB-04 claim form that identifies the specific date range for the services being billed. Located in the upper right-hand section of the form, it consists of two sub-fields: From and Through. This field is critical for institutional billing as it establishes the timeframe for which the facility is seeking reimbursement and directly impacts timely filing calculations.

For inpatient claims, this period typically spans from the date of admission to the date of discharge. For outpatient claims, the "From" and "Through" dates are often identical unless the claim covers a series of recurring treatments or a multi-day observation stay. Payers use these dates to validate that the patient was eligible for benefits during the entire service window and to ensure that the services reported in Field 45: Service Date fall within this overarching period CMS Pub. 100-04 Chapter 25.

When to Use This Field

Field 6 is required for all institutional claims, including inpatient, outpatient, and home health services. The "From" date represents the earliest date of service on the bill, while the "Through" date represents the last date of service or the date of discharge.

Specific Billing Scenarios

• Inpatient Acute Care: The "From" date is the date the patient was formally admitted. The "Through" date is the date the patient was discharged or the end of the current billing increment for interim billing.
• Outpatient Recurring Services: For services like physical therapy or chemotherapy that occur over several weeks, the "From" date is the first session of the month and the "Through" date is the last session of that same month NUBC UB-04 Manual.
• Observation Stays: If a patient is in observation from 11:00 PM on Monday until 2:00 PM on Wednesday, the "From" date is Monday’s date and the "Through" date is Wednesday’s date, even if the patient was never admitted as an inpatient.

Step-by-Step Claim Example

A 68-year-old Medicare beneficiary is admitted to an acute care hospital for a hip replacement on October 1, 2025. The patient experiences minor complications and is not discharged until October 5, 2025.

1. Field 4 (Type of Bill): The biller enters 111 (Hospital, Inpatient, Admit Through Discharge).
2. Field 6 (Statement Covers Period): The biller enters 100125 in the "From" box and 100525 in the "Through" box.
3. Field 12 (Admission Date): This must match the "From" date in Field 6, so 100125 is entered.
4. Field 17 (Patient Status): The biller enters 01 (Discharged to home) because the "Through" date represents a final discharge.
5. Field 42-47 (Service Lines): All revenue codes and service dates listed must fall between 10/01/2025 and 10/05/2025.

Payer Response: The Medicare Administrative Contractor (MAC) validates that the patient had active Part A coverage for the entire 5-day span. Because the "Through" date (10/05) is within the timely filing limit and matches the discharge status, the claim is accepted for DRG-based reimbursement CMS Pub. 100-04 Chapter 25.

Common Mistakes & Audit Red Flags

• Service Date Mismatch: An "instant denial" occurs if any date in Field 45: Service Date falls outside the range defined in Field 6. For example, if Field 6 ends on 10/05 but a lab charge is dated 10/06, the claim will be rejected.
• Spanning Fiscal Years: With few exceptions (such as Home Health PPS), Medicare claims generally cannot span two accounting years. A claim with a "From" date in December and a "Through" date in January may require splitting into two separate bills to accommodate annual deductible resets CMS Pub. 100-04 Chapter 25.
• Incorrect Interim Frequency: If Field 6 covers only a portion of a stay, the Frequency Code in Field 4: Type of Bill must be a 2 (First Interim) or 3 (Continuing Interim). Using a 1 (Admit Through Discharge) for a partial date range triggers a "Length of Stay" audit.

Related Codes & Fields

• Field 4: Type of Bill
• Field 12: Admission Date
• Field 17: Patient Discharge Status
• Field 45: Service Date

References

1. CMS Pub. 100-04 Chapter 25
2. NUBC UB-04 Manual