Box 24 - 33 - How to billing - CMS 1500

Bottom section of the CMS 1500 form

Supplemental information

Shaded line

�� In the shaded area across Fields 24A through 24H, enter supplemental information about the service rendered.
�� If entering more than one item of information on a line, make sure each item begins with a qualifier and is separated by at least 1 blank space.