Wiki Question on billing outpatient - We are certified

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Ballwin, MO
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We are certified as a Rehab Agency by Medicare and bill Medicare on a UB. When billing outpatient PT, OT, ST in a private residence, do we enter our business name AND the patient's address (since it is the service address) in FL1?
 
Field 1 on the UB-04 is used to enter the billing provider's name and address. The provider that is submitting the claim should be listing their information there.
 
But the UB Editor states regarding FL1 "This field contains the name and service location of the provider submitting the bill." Since the "service location" is actually the patient's address do we enter the patient's address with our name? Or just our name with the address of our primary location?
 
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