CMS1500 claim form

The CMS1500 claim form is the accepted billing form for use with Medicare, Medicaid, and many insurers. Forms are available from the American Medical Association, 800/621-8335, the US Government Printing Office, 202/512-1800, and office supply stores.

According to the Center's for Medicare & Medicaid Services (CMS), CMS1500 claim form answers the needs of many health insurers. It is the basic form prescribed by HCFA for the Medicare and Medicaid programs for claims submitted by physicians and suppliers, except for ambulance services. It has also been adopted by CHAMPUS and has the approval of the AMA Council on Medical Services.

Note: Be sure to fill out the claim form completetly to prevent a denied claim.  Each claim form contains a bar code for scanning; therefore, photocopying the form is not recommended and could delay processing or result in a denied claim.