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Preparing the CMS-1500 Form

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Preparing the CMS-1500 Form

CMS 1500

What is the CMS-1500 form?

The CMS-1500 is the red-ink on white paper standard claim form used by physicians and suppliers for claim billing. Although it was developed by The Centers for Medicare and Medicaid (CMS), it has become the standard form used by all insurance carriers.

Who Can Bill Claims using the CMS-1500?

Any non-institutional provider and supplier can use the CMS-1500 for billing medical claims.

  • Physician services
  • Physician assistants
  • Nurse practitioners
  • Clinical nurse specialists
  • Nurse midwives
  • Certified registered nurse anesthetists
  • Clinical psychologists
  • Clinical social workers
  • Home dialysis supplies and equipment
  • Ambulance services
  • Clinical diagnostic laboratory services
Tips for Preparing the CMS-1500
  • Ensure that all data is entered correctly and accurately in the correct fields.
  • Enter insurance information including the patient's name exactly as it appears on the insurance card.
  • Use correct diagnosis codes (ICD-9) and procedure codes (CPT/HCPCS) using modifiers when required.
  • Use only the physical address for the service facility location field.
  • Don't forget to include NPI information where indicated.
More detailed instructions can be found at www.cms.gov or www.nucc.org
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