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National Uniform Billing Committee

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uuid000uo98

Namestring
National Uniform Billing Committee
Legal namestring
American Hospital Association
Websiteurl
nubc.org
Company typeenum
Private
Founded yearint
1975
Descriptiontext

The National Uniform Billing Committee (NUBC) is the designated national standards body for institutional healthcare billing in the United States, established in 1975 and operated under the American Hospital Association (AHA). NUBC develops and maintains the UB-04 data specifications and code sets — the de facto standard for institutional claims submitted by hospitals and other providers to Medicare, Medicaid, TRICARE, BlueCross BlueShield, and commercial payers. The UB-04 standard was codified under the Health Insurance Portability and Accountability Act (HIPAA) of 1996 as part of federal administrative simplification mandates for electronic healthcare transactions.

NUBC's product portfolio centers on three offerings: the Official UB-04 Data Specifications Manual (a subscription-based reference copyrighted by AHA and serving as the only authoritative source of UB data), the Official UB-04 Data File (a licensed Excel-format compilation of the complete sequential code set with no gaps), and the UB-04 Change Implementation Calendar documenting approved changes and effective dates. The committee publishes announcements, responds to emerging care delivery models (e.g., hospital-at-home codes in 2021, disaster alternate care sites in 2020), and submits comment letters to federal regulators on proposed rules affecting electronic transactions.

Revenue is generated through manual subscriptions and data file licensing, though pricing is not publicly disclosed and the committee does not report independent revenue, consistent with its role as a nonprofit standards body under AHA governance. NUBC holds biannual public meetings (April and August), joint sessions with the National Uniform Claim Committee (NUCC), and includes representatives from CMS, America's Health Insurance Plans (AHIP), Blue Cross Blue Shield Association, the Federation of American Hospitals (representing HCA and Community Health Systems), the Healthcare Financial Management Association (HFMA), X12, the Defense Health Agency, and state-level uniform billing committees.

Short descriptiontext

The National Uniform Billing Committee (NUBC), formed in 1975 and operated under the American Hospital Association, is the U.S. standards body that develops and maintains the UB-04 institutional billing specifications and code sets used by hospitals, Medicare, Medicaid, TRICARE, and commercial payers for electronic claims processing.

Operating statusenum
Operating
Ownership categoryenum
Headcount rangeband
101–250
akta.pro rankint
HeadquartersChicago, United States
HQ citystring
Chicago
HQ countrystring
United States
HQ regionstring
North America
Markets served

Serves global market

Offices1 record

Each record includes

City, Country, Type, Description, Source

Keyword5 values
healthcare billing standards, institutional claim data, UB-04 specifications, medical billing codes, administrative simplification
Industry3 codes
PRIMARYFSAMAJAH
Healthcare Billing & Patient Payments Presentment
SECONDARYBPAAAFAH
Fraud, Waste & Abuse (FWA) Detection & SIU Support
SECONDARYHLACAIAI
FHIR/HL7 Data Repositories & Canonical Data Models
Healthcare & Life Sciences/Digital Health & Health IT/Healthcare Data Platforms, Warehousing & Governance
NAICS code1 code
  • Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds524292
SIC code1 code
  • Hospital & Medical Service Plans6324
Product category
Healthcare Billing Standards
No data
GTM motion1 record

Each record includes

Type, Description, Source

Revenue model2 records
1Manual Subscriptions
TypeSubscription Recurring
Description

Subscription to the Official UB-04 Data Specifications Manual, which is copyrighted by the American Hospital Association. This is the only official source of UB Data.

nubc.org
2UB-04 Data File Licensing
TypeLicensing Royalties
Description

Licensing of the Official UB-04 Data File containing the complete set of NUBC codes in sequential order with no gaps.

nubc.org
Marketing channels3 records

Each record includes

Title, Type, Stage, Description, Source

Distribution channels2 records

Each record includes

Title, Type, Scope, Target buyer, Description, Source

Cost components3 values
Personnel, Operations, Others
GTM typeB2B
B2B
Offering typeServices
Services
Core offering1 text field

NUBC develops and maintains the UB-04, the standardized billing form and data specifications used nationwide by institutional healthcare providers and payers for institutional claims. It monetizes this standard by offering the Official UB-04 Data Specifications Manual on a subscription basis and the Official UB-04 Data File (complete code set in Excel) via licensing, both administered through the American Hospital Association.

Differentiator
Functional benefit
Problem solved
Quantifiable outcome1 of 2 values shown
  • More than 98% of hospital claims submitted electronically to Medicare program
+1 more record
Product overview1 text field

The National Uniform Billing Committee offers a subscription-based product portfolio centered on the UB-04 institutional billing standard. The core offering is the Official UB-04 Data Specifications Manual, which is the only authoritative source for UB data specifications used by institutional healthcare providers and payers nationwide. Complementary products include the Official UB-04 Data File (a complete code reference in Excel format) and the UB-04 Change Implementation Calendar documenting updates and effective dates. These products support administrative simplification goals outlined in HIPAA.

Product and service1 record
1Official UB-04 Data Specifications Manual
Scale indicator2 records

Each record includes

Type, Value, Description, Source

Partnership10 partners
Strategic tierCoreTypeStrategic or Co-development PartnerAnnounced on1975-01-01
Description

CMS participates as a member organization representing Medicare and Medicaid programs, providing federal government perspective on claims processing requirements.

Strategic tierCoreTypeOthers
Description

AHA hosts and administers NUBC. The Official UB-04 Data Specifications Manual is copyrighted by AHA.

3National Uniform Claim Committee (NUCC)
Strategic tierCoreTypeStrategic or Co-development Partner
Description

NUCC holds joint meetings with NUBC. NUCC handles professional claim standards while NUBC handles institutional claim standards.

nubc.org
Strategic tierMajorTypeStrategic or Co-development Partner
Description

AHIP provides representation from health insurance plans for commercial payer perspective on billing requirements.

Strategic tierMajorTypeStrategic or Co-development Partner
Description

BCBSA participates as member representing Blue Cross Blue Shield plans for standardization of claims processing.

Strategic tierMajorTypeStrategic or Co-development Partner
Description

FAH represents for-profit hospital systems including HCA and Community Health Systems.

Strategic tierMajorTypeStrategic or Co-development Partner
Description

HFMA provides expertise on healthcare financial management and revenue cycle perspectives.

Strategic tierCoreTypeTechnology or Integration
Description

X12 develops electronic data interchange (EDI) standards including the 837 transactions that carry UB-04 data.

Strategic tierMajorTypeStrategic or Co-development Partner
Description

DHA administers the TRICARE program and benefits, representing military healthcare claims requirements.

10State Uniform Billing Committees (SUBCs)
Strategic tierMajorTypeChannel Partner/ Reseller/ Distributor
Description

SUBCs handle state-level implementation and dissemination of UB-82/UB-04 manuals reflecting national guidelines and unique state billing requirements.

nubc.org
Recent move6 records

Each record includes

Date, Type, Title, Description, Source

Expansion highlight5 records

Each record includes

Type, Description

Peers10 records
TypeBroad incumbent
Description

AMA owns and maintains the CPT code set, the dominant procedure coding standard that interfaces with UB-04 revenue codes on institutional claims. AMA participates in NUBC governance through the NUCC and coordinates across professional and institutional coding.

2National Council for Prescription Drug Programs (NCPDP)
TypeEmerging player
Description

NCPDP is a designated standards maintenance organization for pharmacy transactions (Telecommunication and SCRIPT standards), analogous to NUBC's role for institutional claims. The two organizations address different but adjacent healthcare EDI domains under the HIPAA umbrella.

TypeBroad incumbent
Description

CMS mandates the use of UB-04 data content under HIPAA for Medicare and Medicaid institutional claims and is itself a NUBC member organization. CMS regulatory rulemaking defines how UB-04 data elements are consumed in federal programs.

4ASC X12
TypeDirect peer
Description

X12 develops the EDI standards (including the 837 Institutional Health Claim transaction) that carry UB-04 data elements electronically. NUBC's UB-04 data content and X12's 837 transaction set are tightly coupled layers of the same institutional billing workflow.

TypeOthers
Description

AHIMA is the professional association for health information management whose members (HIM/coding professionals) are primary users of UB-04 specifications in hospitals. AHIMA's credentialing and education ecosystem depends on UB-04 data fluency.

TypeOthers
Description

HFMA is a NUBC member organization representing healthcare financial management and revenue cycle expertise. HFMA's peer-reviewed revenue cycle maps and industry guidance reinforce adoption of UB-04 standards across hospitals.

TypeEmerging player
Description

HL7 develops FHIR and other healthcare interoperability standards that increasingly complement or compete with traditional EDI-based claim standards like UB-04. As a Designated Standards Maintenance Organization, HL7 is part of the same regulatory standards ecosystem NUBC operates in.

8National Uniform Claim Committee (NUCC)
TypeDirect peer
Description

NUCC develops and maintains the professional (non-institutional) claim standard, the CMS-1500, while NUBC maintains the institutional UB-04. The two committees hold joint meetings and together define the US healthcare billing standards ecosystem.

TypeBroad incumbent
Description

ONC drives US healthcare interoperability policy including FHIR-based API standards and USCDI. ONC's policy direction shapes whether UB-04 remains the authoritative institutional claim data format or is progressively supplemented/replaced by API-native standards.

TypeOthers
Description

WEDI is a healthcare industry advisor to HHS on electronic data interchange and administrative simplification, the same policy goals NUBC supports under HIPAA. WEDI's policy work and convenings shape the regulatory environment in which UB-04 operates.

Market position
Weaknesses5 records

Each record includes

Headline, Details, Source

Competitive moat5 records

Each record includes

Type, Details

Key risks6 records

Each record includes

Headline, Details, Source

Key highlights7 records

Each record includes

Headline, Details, Source

Customer concentration

Classification, Details

Segment3 records

Each record includes

Title, Type, Primary, Description, Pain point addressed, Use case, Source

Ideal customer profile3 records

Each record includes

Profile, Firmographic size, Sales motion, Sales cycle length, Buying structure, Purchase trigger, Buyer persona, Geography, Industry vertical, Primary use case, Description, Pain points, Evidence proof points, Target buyer

Technology focused
No
API detail
Has APIbool
No

Docs URL, Description

AI maturity
App detail

Has app

Feature2 records

Each record includes

Title, Differentiator, Description, Source

Core technology
Revenue estimate
Valuation estimate
Number of profiles
Profiles17 records

Each record includes

Name, Designation, Designation category, Overview, Profile commentary, Source

No data
No data
Funding overview

Funding stage, Last funding date, Total funding USD

Funding rounds

Each record includes

Round, Amount USD, Date, Pre money valuation, Total investors, Investors, News

Investors

Each record includes

Name, Type, Date of entry, Rounds participated, Website

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Each record includes

Name, Acquisition type, Announced date, Completed date, Status, Website, News

Investment

Each record includes

Name, Round, Announced date, Lead investor, Website, News

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

National Uniform Billing Committee

Healthcare Billing Standardsnubc.org

The National Uniform Billing Committee (NUBC), formed in 1975 and operated under the American Hospital Association, is the U.S. standards body that develops and maintains the UB-04 institutional billing specifications and code sets used by hospitals, Medicare, Medicaid, TRICARE, and commercial payers for electronic claims processing.

What National Uniform Billing Committee does

The National Uniform Billing Committee (NUBC) is the designated national standards body for institutional healthcare billing in the United States, established in 1975 and operated under the American Hospital Association (AHA). NUBC develops and maintains the UB-04 data specifications and code sets — the de facto standard for institutional claims submitted by hospitals and other providers to Medicare, Medicaid, TRICARE, BlueCross BlueShield, and commercial payers. The UB-04 standard was codified under the Health Insurance Portability and Accountability Act (HIPAA) of 1996 as part of federal administrative simplification mandates for electronic healthcare transactions.

NUBC's product portfolio centers on three offerings: the Official UB-04 Data Specifications Manual (a subscription-based reference copyrighted by AHA and serving as the only authoritative source of UB data), the Official UB-04 Data File (a licensed Excel-format compilation of the complete sequential code set with no gaps), and the UB-04 Change Implementation Calendar documenting approved changes and effective dates. The committee publishes announcements, responds to emerging care delivery models (e.g., hospital-at-home codes in 2021, disaster alternate care sites in 2020), and submits comment letters to federal regulators on proposed rules affecting electronic transactions.

Revenue is generated through manual subscriptions and data file licensing, though pricing is not publicly disclosed and the committee does not report independent revenue, consistent with its role as a nonprofit standards body under AHA governance. NUBC holds biannual public meetings (April and August), joint sessions with the National Uniform Claim Committee (NUCC), and includes representatives from CMS, America's Health Insurance Plans (AHIP), Blue Cross Blue Shield Association, the Federation of American Hospitals (representing HCA and Community Health Systems), the Healthcare Financial Management Association (HFMA), X12, the Defense Health Agency, and state-level uniform billing committees.

National Uniform Billing Committee firmographics

Firmographics
Name
National Uniform Billing Committee
Legal name
American Hospital Association
Website
https://nubc.org
Company type
Private
Founded year
1975
Operating status
Operating
Headcount range
101–250 employees
Short description
The National Uniform Billing Committee (NUBC), formed in 1975 and operated under the American Hospital Association, is the U.S. standards body that develops and maintains the UB-04 institutional billing specifications and code sets used by hospitals, Medicare, Medicaid, TRICARE, and commercial payers for electronic claims processing.
Ownership category
akta.pro rank

National Uniform Billing Committee industry classification

Industry
Product category
Healthcare Billing Standards
NAICS
Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)
SIC
Hospital & Medical Service Plans (6324)
akta.pro industry
PRIMARYFSAMAJAH
Healthcare Billing & Patient Payments Presentment
SECONDARYBPAAAFAH
Fraud, Waste & Abuse (FWA) Detection & SIU Support
SECONDARYHLACAIAI
FHIR/HL7 Data Repositories & Canonical Data Models
Healthcare & Life Sciences/Digital Health & Health IT/Healthcare Data Platforms, Warehousing & Governance

Keywords

  • Healthcare billing standards
  • Institutional claim data
  • UB-04 specifications
  • Medical billing codes
  • Administrative simplification

Where National Uniform Billing Committee is headquartered

Location

Headquarters

HQ city
Chicago
HQ country
United States
HQ region
North America

Offices1 record

Markets served

National Uniform Billing Committee business model

Business model
GTM type
B2B
Offering type
Services
Cost components
Personnel, Operations, Others

Revenue model

  1. Manual Subscriptions: Subscription to the Official UB-04 Data Specifications Manual, which is copyrighted by the American Hospital Association. This is the only official source of UB Data.
  2. UB-04 Data File Licensing: Licensing of the Official UB-04 Data File containing the complete set of NUBC codes in sequential order with no gaps.

Go-to-market motion1 record

Distribution channels2 records

Marketing channels3 records

National Uniform Billing Committee product offering

Product offering

Core offering

NUBC develops and maintains the UB-04, the standardized billing form and data specifications used nationwide by institutional healthcare providers and payers for institutional claims. It monetizes this standard by offering the Official UB-04 Data Specifications Manual on a subscription basis and the Official UB-04 Data File (complete code set in Excel) via licensing, both administered through the American Hospital Association.

Product overview

The National Uniform Billing Committee offers a subscription-based product portfolio centered on the UB-04 institutional billing standard. The core offering is the Official UB-04 Data Specifications Manual, which is the only authoritative source for UB data specifications used by institutional healthcare providers and payers nationwide. Complementary products include the Official UB-04 Data File (a complete code reference in Excel format) and the UB-04 Change Implementation Calendar documenting updates and effective dates. These products support administrative simplification goals outlined in HIPAA.

Differentiator

Problem solved

Functional benefit

Products and services

  • Official UB-04 Data Specifications Manual

Quantifiable outcome

  • More than 98% of hospital claims submitted electronically to Medicare program
  • +1 more outcomes

Companies that use National Uniform Billing Committee

Customer profile

Segments3 records

Ideal customer profiles3 records

National Uniform Billing Committee technology and API

Technology

Technology focussed No

API detail

Has API
No
API docs
API detail

Core technology

AI maturity

App detail

Feature2 records

National Uniform Billing Committee partnerships and signals

Strategic signal

Partnerships

Ten partnerships are on record, tiered core and major.

  • Centers for Medicare & Medicaid Services (CMS)coreStrategic or Co-development Partner · 1 January 1975CMS participates as a member organization representing Medicare and Medicaid programs, providing federal government perspective on claims processing requirements.
  • American Hospital AssociationcoreOthersAHA hosts and administers NUBC. The Official UB-04 Data Specifications Manual is copyrighted by AHA.
  • National Uniform Claim Committee (NUCC)coreStrategic or Co-development PartnerNUCC holds joint meetings with NUBC. NUCC handles professional claim standards while NUBC handles institutional claim standards.
  • America's Health Insurance PlansmajorStrategic or Co-development PartnerAHIP provides representation from health insurance plans for commercial payer perspective on billing requirements.
  • Blue Cross Blue Shield AssociationmajorStrategic or Co-development PartnerBCBSA participates as member representing Blue Cross Blue Shield plans for standardization of claims processing.
  • Federation of American HospitalsmajorStrategic or Co-development PartnerFAH represents for-profit hospital systems including HCA and Community Health Systems.
  • Healthcare Financial Management AssociationmajorStrategic or Co-development PartnerHFMA provides expertise on healthcare financial management and revenue cycle perspectives.
  • X12coreTechnology or IntegrationX12 develops electronic data interchange (EDI) standards including the 837 transactions that carry UB-04 data.
  • Defense Health AgencymajorStrategic or Co-development PartnerDHA administers the TRICARE program and benefits, representing military healthcare claims requirements.
  • State Uniform Billing Committees (SUBCs)majorChannel Partner/ Reseller/ DistributorSUBCs handle state-level implementation and dissemination of UB-82/UB-04 manuals reflecting national guidelines and unique state billing requirements.

Scale indicators2 records

Recent moves6 records

Expansion highlights5 records

National Uniform Billing Committee competitors and assessment

Company assessment

Broad incumbents

  • American Medical Association (AMA): AMA owns and maintains the CPT code set, the dominant procedure coding standard that interfaces with UB-04 revenue codes on institutional claims. AMA participates in NUBC governance through the NUCC and coordinates across professional and institutional coding.
  • Centers for Medicare & Medicaid Services (CMS): CMS mandates the use of UB-04 data content under HIPAA for Medicare and Medicaid institutional claims and is itself a NUBC member organization. CMS regulatory rulemaking defines how UB-04 data elements are consumed in federal programs.
  • Office of the National Coordinator for Health IT (ONC): ONC drives US healthcare interoperability policy including FHIR-based API standards and USCDI. ONC's policy direction shapes whether UB-04 remains the authoritative institutional claim data format or is progressively supplemented/replaced by API-native standards.

Emerging players

  • National Council for Prescription Drug Programs (NCPDP): NCPDP is a designated standards maintenance organization for pharmacy transactions (Telecommunication and SCRIPT standards), analogous to NUBC's role for institutional claims. The two organizations address different but adjacent healthcare EDI domains under the HIPAA umbrella.
  • HL7 (Health Level Seven International): HL7 develops FHIR and other healthcare interoperability standards that increasingly complement or compete with traditional EDI-based claim standards like UB-04. As a Designated Standards Maintenance Organization, HL7 is part of the same regulatory standards ecosystem NUBC operates in.

Direct peers

  • ASC X12: X12 develops the EDI standards (including the 837 Institutional Health Claim transaction) that carry UB-04 data elements electronically. NUBC's UB-04 data content and X12's 837 transaction set are tightly coupled layers of the same institutional billing workflow.
  • National Uniform Claim Committee (NUCC): NUCC develops and maintains the professional (non-institutional) claim standard, the CMS-1500, while NUBC maintains the institutional UB-04. The two committees hold joint meetings and together define the US healthcare billing standards ecosystem.

Others

  • American Health Information Management Association (AHIMA): AHIMA is the professional association for health information management whose members (HIM/coding professionals) are primary users of UB-04 specifications in hospitals. AHIMA's credentialing and education ecosystem depends on UB-04 data fluency.
  • Healthcare Financial Management Association (HFMA): HFMA is a NUBC member organization representing healthcare financial management and revenue cycle expertise. HFMA's peer-reviewed revenue cycle maps and industry guidance reinforce adoption of UB-04 standards across hospitals.
  • Workgroup for Electronic Data Interchange (WEDI): WEDI is a healthcare industry advisor to HHS on electronic data interchange and administrative simplification, the same policy goals NUBC supports under HIPAA. WEDI's policy work and convenings shape the regulatory environment in which UB-04 operates.

Market position

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

National Uniform Billing Committee financial estimates

Financial estimate

Revenue estimate

Valuation estimate

National Uniform Billing Committee leadership team

Management profile

Number of profiles

Profiles17 records

National Uniform Billing Committee funding detail

Funding detail

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

National Uniform Billing Committee M&A and investment

M&A and investment

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about National Uniform Billing Committee

What does National Uniform Billing Committee do?

NUBC develops and maintains the UB-04, the standardized billing form and data specifications used nationwide by institutional healthcare providers and payers for institutional claims. It monetizes this standard by offering the Official UB-04 Data Specifications Manual on a subscription basis and the Official UB-04 Data File (complete code set in Excel) via licensing, both administered through the American Hospital Association.

Is National Uniform Billing Committee a public or private company?

National Uniform Billing Committee is a private company. It is classified as nonprofit foundation owned and is currently operating.

When was National Uniform Billing Committee founded?

National Uniform Billing Committee was founded in 1975. It employs 101 to 250 people.

Where is National Uniform Billing Committee based?

National Uniform Billing Committee is headquartered in Chicago, United States, in the North America region.

How does National Uniform Billing Committee make money?

Two revenue lines are on record. Manual Subscriptions are the primary driver. The others are UB-04 Data File Licensing.

Who are National Uniform Billing Committee's main competitors?

Broad incumbents on record are American Medical Association (AMA), Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator for Health IT (ONC). Emerging players are National Council for Prescription Drug Programs (NCPDP) and HL7 (Health Level Seven International). Direct peers are ASC X12 and National Uniform Claim Committee (NUCC). Others are American Health Information Management Association (AHIMA), Healthcare Financial Management Association (HFMA) and Workgroup for Electronic Data Interchange (WEDI).

Does National Uniform Billing Committee have an API?

No public API is recorded for National Uniform Billing Committee.

What industry is National Uniform Billing Committee in?

National Uniform Billing Committee's product category is Healthcare Billing Standards. Its primary akta.pro industry code is FSAMAJAH, Healthcare Billing & Patient Payments Presentment, with a secondary code of BPAAAFAH, Fraud, Waste & Abuse (FWA) Detection & SIU Support. Its NAICS code is 524292 and its SIC code is 6324.

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