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UB-04 / CMS-1450 Field Guide

UB-04 Form Locator 6: Statement covers period

The from and through dates for the billing period. These dates help define the span covered by the institutional claim.

Reviewed September 2026 · Educational reference — verify payer and program requirements.

What Form Locator 6 reports

The from and through dates for the billing period. These dates help define the span covered by the institutional claim.

What to check

  • Use the current institutional claim instructions for the payer and bill type.
  • Confirm the value matches the source record, provider enrollment, authorization or revenue-line detail that supports the claim.
  • Do not substitute a narrative note when a designated code or identifier is required.
  • Reconcile related form locators before filing.
Medicare reference: CMS publishes form locator completion guidance in Chapter 25 of the Medicare Claims Processing Manual. NUBC maintains the UB-04 data specifications and code sets used broadly across institutional billing.