CMS 1500 - points to remember

Claim form billing instructions - CMS 1500

Overview


This step-by-step presentation is intended to provide information to assist those who bill the Division of Medical Assistance Programs (DMAP) for Medicaid services complete the 08/05 CMS 1500 billing form correctly the first time. If applicable, this presentation is to be used in conjunction with General Rules, provider guidelines and supplemental information.

Before you bill

�� Read your provider guidelines.
�� Verify client eligibility on the date of service.
�� Make sure you bill all prior resources first.
�� Use commercially available “red form” versions of the CMS 1500.

A few tips!

�� When submitting handwritten claim forms, you must use blue or black ink; never use red ink.
�� Make sure your handwriting is legible.
�� If possible, submit no more than six lines of services per claim form.
�� Do not use liquid whiteout.
�� Check your printer alignment.



Services billed on the CMS 1500
�� Durable Medical Equipment Services
�� School Based Medical Services
�� Professional Services
• Contract RN
• Licensed professionals

�� Non-Medical Professional
• Secured Transportation
• Copy Services
• Miscellaneous Medical Services
• Sex Offender Polygrapher
• Wheelchair Coach/Services
• Taxi

�� Medical Professional Providers
• Air/Ground Ambulance
• Ambulatory Surgical Center
• Billing Provider
• Billing Service/Agent
• Chemical Dependency
• Chiropractor
• Family Planning Clinic
• Free Standing Birthing Center
• Hearing Aid Provider
• Independent Lab
• Licensed Midwife
• Naturopath
• Mental Health
• Nurse Anesthetist
• Nurse Practitioner
• Occupational Therapist
• Optometrist
• Physical Therapist
• Physician
• Podiatrist
• Portable X-Ray
• Psychologist
• Public Clinic
• Registered Nurse
• Rural Health Center
• Federally Qualified Health Center
• Dispensing Optician
• Indian Health
• Lifeline
• Targeted Case Management