Learn about the CMS 1500 claim form, its purpose, how to obtain and fill it correctly, and its importance in healthcare billing. Understand submission requirements and electronic alternatives to streamline the claim process for providers handling Medicare and other insurance claims.

Guide to the CMS 1500 Insurance Claim Form

The CMS 1500 is an official form used for submitting health insurance claims by healthcare providers. Developed by the Centers for Medicare & Medicaid Services (CMS), this standardized document enables providers to bill for medical services rendered. Created by the National Uniform Claim Committee (NUCC), the form is widely used for Medicare and various other government and private insurance plans.

While CMS does not distribute the form directly, it can be purchased from the U.S. Government Printing Office or local suppliers for a small fee.

Available in single or multipart versions, including laser and continuous feed options, printed forms are mandatory for claim processing, as photocopies are not accepted. Accurate specifications, such as OCR-compatible colors and sizes, are critical for automated data extraction to avoid delays. Electronic submissions using scanned OCR forms are also allowed, enhancing efficiency for paper and digital claims alike.

The CMS 1500 is the standard form for billing Medicare Fee-For-Service claims when submitting by paper. The claim typically must be filed within 12 months of the service date, with some exceptions. This form is essential for billing services provided by physicians, therapists, labs, social workers, and other healthcare providers. Following all completion instructions carefully ensures proper reimbursement and smooth processing.