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New CMS 1500 Form for Filing Physician and Supplier Medicare Claims

CMS 1500 Form for Filing Physician and Supplier Medicare Claims

Publisher: Health and Human Services Dept.

Description: The new Form CMS-1500 (formerly HCFA 1500) is the basic form prescribed by the U.S. Government's Centers for Medicare & Medicaid Services (CMS) for filing physician and supplier Medicare claims. CMS 1500 is used by numerous Federal agencies and programs, including: Railroad Retirement Board (RRB-1500); Office of Worker Compensation Programs (OWCP-1500) as well as Black Lung Federal Employees' Compensation Act (FECA), and Civilian Health and Medical Program of the Uniformed Services (CHAMPUS).

The new CMS Form 1500 is available in the following configurations:

Health Insurance Claim Form, CMS-1500 Claim Form (Single Sheet)

Publisher: Health and Human Services Dept., Centers for Medicare and Medicaid Services

Description: $26/Package of 100.

Price: $26.00

Health Insurance Claim Form (CMS-1500) (2 Part Snapout)

Publisher: Health and Human Services Dept., Centers for Medicare and Medicaid Services

Description: $29/Package of 100.

Price: $29.00

Health Insurance Claim Form, CMS-1500 or HCFA 1500 Claim Form (2 part Continuation)

Publisher: Health and Human Services Dept., Centers for Medicare and Medicaid Services

Description: $78/Carton of 1,400.

Price: $78.00

Health Insurance Claim Form (CMS-1500) (1-Part Continuation)

Publisher: Health and Human Services Dept., Centers for Medicare and Medicaid Services

Description: $97/Carton of 2,500.

Price: $97.00

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Last updated: September 20, 2006