CMS-1500

When you qualify to submit paper claims, you must use the CMS-1500 to bill a MAC.

The National Uniform Claim Committee (NUCC), working with CMS, developed and maintains the CMS-1500 claim form. The 02/12 version is the current version.

You can submit up to 6 lines of service on a CMS-1500. However, the form doesn't allow you to bill up to 50 lines of service as you can with the 837P.

You can download a copy of the form on the CMS Form List webpage, but you can't use this copy to submit claims. The copy doesn't correctly replicate form colors that enable automated form reading.