What is a HCFA 1500 Claim Form?

The HCFA Form 1500 (08/05) Health Insurance Claim Form was used prior to April 1, 2014 by professional physicians and clinical practitioners for non-institutional billing of federal insurance programs such as Medicare, Medicaid and Tricare.

The HCFA Form 1500 is obsolete, as is all HCFA 1500 software. HCFA 1500 insurance claim forms are no longer accepted, and have been replaced by the new CMS 1500 (02/12) Health Insurance Claim Form, starting April 1, 2014.

The new CMS Form 1500 (OMB-0938-1197) 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 (02/12) became mandatory for non-insitutional (professional) medical claims billing and reimbursement from federal insurance programs like Medicare, Medicaid and Tricare.

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

For federal insurance (Medicare, Medicaid, Tricare) claims, the only paper claim forms accepted are those printed in Flint OCR Red (J6983), (or an exact color match) ink. Paper CMS 1500 claim forms are processed by Optical Character Recognition to extract the claim details. The red ink on the form is removed, isolating the black claim data. Because the position and size of the printed claim data are critical for accurate extraction and recognition, PDF-printed or photocopied paper claim forms may not be accepted, and may result in delays for reimbursement of the claim. The only 100% reliable solution for Medicare/Medicaid claims is to use dedicated CMS 1500 software to print the claim data perfectly aligned onto pre-printed, red CMS 1500 paper forms.

What types of professional (non-institutional) 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 can I fill-in and print-out a CMS 1500 Form?

Introducing FormDocs Fillable CMS 1500 Claim Form Software...

FormDocs CMS-1500 Form Software makes filling-in, printing, and managing CMS 1500 health insurance claim forms affordable and easy! Fill-in a full-size, red 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 package with rich form-filling features, thorough field validation to reduce data entry errors, and perfect print alignment of data on the claim form. PDF-based fillable CMS 1500 products simply cannot match FormDocs CMS-1500 software on accuracy, features and price!

FormDocs CMS-1500, starting at only $69.95, offers the most value of any CMS 1500 Form-Filling 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.