What is a CMS 1500 Claim Form?

The OMB-0938-1197 CMS FORM 1500 (02/12) Health Insurance Claim Form is used by non-institutional professionals such as physicians and clinical practitioners for medical claims billing and reimbursement from federal insurance programs such as Medicare, Medicaid and Tricare. Although the CMS 1500 Claim Form is requisite for reimbursement for Medicare claims and other federal insurance plans, it has also been adopted for claims submission by most major commercial insurance carriers.

The CMS 1500 (02/12) Claim Form is the successor to the now-obsolete HCFA 1500 (08/05) Claim Form. The new Form 1500 was designed by the National Uniform Claim Committee (NUCC), and was approved for use by the Centers for Medicare and Medicaid Services (CMS) in 2013. Starting April 1, 2014, the new CMS 1500 form became mandatory for all professional Medicare claim form submission.

CMS 1500 Medicare claim form
CMS 1500 Insurance Claim Form (02/12) - Click for larger image

For professional claims billing federal insurance (Medicare, Medicaid, Tricare), the only acceptable paper claim forms are those printed in Flint OCR Red, J6983, (or an exact color match) ink. Paper CMS 1500 claim forms are processed by OCR (Optical Character Recognition) to extract the claim details. The special red ink on the form is removed, isolating the black-ink-colored claim data. Since the position and size of the printed claim data are critical for accurate extraction and recognition, printed PDF or photocopied paper claims may not be accepted, and can result in unnecessary delays for reimbursement of the claim. The only reliable solution for Medicare claims is to use dedicated software to print the claim data perfectly aligned onto pre-printed, red CMS 1500 paper forms.

What types of professional Providers and Suppliers can bill claims using insurance claim form 1500?

  • Physician services
  • Physician assistants
  • Clinical psychologists
  • Mental health therapists
  • Chiropractors
  • Nurse practitioners
  • Clinical nurse specialists
  • Nurse midwives
  • Certified registered nurse anesthesiologists
  • Accupuncturists
  • Massage therapists
  • Clinical social workers
  • Ambulance services
  • Clinical diagnostic laboratory services
  • Home dialysis equipment suppliers

How do I fill-in and print-out a CMS 1500 Form?

Introducing FormDocs Fillable CMS 1500 Claim Form Software...

FormDocs CMS-1500 Software makes filling-in, printing, and managing CMS 1500 health insurance claim forms affordable and easy! Fill-in a full-size, color CMS 1500 insurance claim form right on your screen. Securely store and manage all your filled-in claim forms. Organize, print-out, plus optionally e-file* and track your insurance claims so you can get reimbursed faster!

And because FormDocs CMS-1500 is dedicated electronic forms software, built from the ground up for the purpose of filling-in, printing and managing forms, you get a robust software platform with rich form-filling features, thorough field validation to reduce data entry errors, and perfect print alignment of data onto the claim form. No Form 1500 PDF product can do all that, AND match FormDocs CMS-1500 on accuracy, features and price!

FormDocs CMS-1500, starting at only $69.95, offers the most value of any fillable CMS Form 1500 Software in it's class.

Click here to learn more, and then download a free trial of FormDocs CMS-1500 software to try it for yourself.

* Optional Claim e-Filing feature requires enrollment with third-party Medical Claims Clearinghouse.