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Medicare Billing: CMS-1450 & 837I

Loop 2400 SV2/FL 48

situationally required icon

Medicare requires only if there are non-covered charges for the related revenue code in FL 42.

Table 43: Loop 2400 SV2/FL 48 Field
Non-Covered ChargesSource
Enter the total non-covered charges for the related revenue code in FL 42 here.Patient or provider records

Electronic claims accept up to 450 submitted line items listed in FLs 42 through 48. For the CMS-1450, this means that the MAC accepts claims of up to 9 pages.