PREPARING THE CMS-1500 CLAIM FORM
The Form CMS-1500 (Health Insurance Claim Form) is the standard claim form used by a non-institutional provider or supplier to bill Medicare contractors and durable medical equipment contractors when a provider qualifies for a waiver from the Administrative Simplification Compliance Act (ASCA) requirement for electronic submission of claims.
The National Uniform Claim Committee (NUCC) is responsible for the maintenance of the form CMS-1500. CMS and contractors do not provide the form to providers for claim submission. Forms may be purchased from the U.S. Government Printing Office at (866) 512-1800, local printing companies in your area and/or office supply stores. Each of these sources sells the Health Insurance Claim Form CMS-1500 in various configurations (single part, multi-part, continuous feed, laser, etc.)
