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Implementation of Lesser of Logic for UB04 Medicare claims

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May 29, 2026
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Claims & Coding
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Claims & Coding
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Beginning May 2026, this notice informs Medicare Advantage (MA) providers who bill on a UB04 claim that Lesser of Logic will be implemented over the next several months for services provided.

Provider action required

Providers should carefully review their billed charges to ensure accuracy and alignment with contractual expectations.

Providers may contact their contract representative with any questions.

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