CMS 1500 Claim Form - Summary
The CMS 1500 claim form is essential for non-institutional providers and suppliers who need to submit claims to Medicare carriers and durable medical equipment regional carriers (DMERCs). This form is significant when a provider qualifies for a waiver from the Administrative Simplification Compliance Act (ASCA), allowing them to bypass electronic submission for certain claims.
Understanding the CMS 1500 Claim Form
This claim form is also utilized for billing some Medicaid State Agencies. For detailed information, it is advisable to reach out to your specific Medicaid State Agency directly. The design and ongoing maintenance of the CMS-1500 form are overseen by the National Uniform Claim Committee (NUCC). However, please note that CMS does not provide the forms to providers for submitting claims.
If you need to purchase the claim forms, you have several options. You can contact the U.S. Government Printing Office at 1-866-512-1800, or you can visit local printing companies and office supply stores in your area. All these vendors offer the CMS-1500 claim form in different configurations, such as single part, multi-part, continuous feed, and laser versions.
Download CMS 1500 Claim Form in PDF
To obtain the CMS 1500 claim form conveniently, you can download it in PDF format using the link provided below. Having this form ready will help streamline your billing process. 📄