CMS 1500 Claim Form, Codes & Information
Diagnosis (Dx)ICD-10-CM Codes0 ICD-9-CM - Volume 1
Procedure (Tx)CPT® - Level I Codes & Modifiers HCPCS - Level II Codes & Modifiers
Claim Form CodesCondition Codes (10d) Place of Service Codes (24b) Other CMS-1500 Codes Workers' Comp Report/Trans Codes Type of Service (TOS) Indicators (old)
CMS 1500 Forms & SoftwareCMS 1500 02/12 - Black Form CMS 1500 02/12 - Red Form Purchase CMS 1500 Claim Forms
Helps & GuidesCMS 1500 InstaGuide NUCC & Medicare CMS 1500 02/12 Instructions CMS 1500 02/12 Changes Medicare FactSheet: 837P/CMS-1500
NewslettersCPT Assistant +Archives
Medicare Manuals & GuidesPUB100 - Medicare Guides and Manuals E&M Guidelines & Procedures Medicare Contractors - LCDs & Articles NCDs - National Coverage Determinations PQRS Program More... (Forms, FAQs, NCCI, etc.)
SearchFind-A-Code Search - One simple search! Click-A-Dex™ - Fast index searching. Build-A-Code™ - Code list builder.
My ToolsMy Code Lists - Code Details & Fees. Manage Code Lists My Account - Personalize Find-A-Code. SuperBill Builder
Scrubbing & ValidationScrub-A-Claim™ - Claim Scrubber NCCI Edit Validator - NON-Facility Edition
CMS-1500 Claim FormThe 1500 Health Insurance Claim Form answers the needs of many health payers. It is the basic paper claim form prescribed by many health plans for claims submitted by physicians and suppliers, and in some cases, for ambulance services.
In the 1960s there were a number of different claim forms and coding systems required by third-party payers to communicate information regarding procedures and services to agencies concerned with insurance claims. However, there was no standardized form for physicians and other health care providers to report health care services. Therefore, the American Medical Association (AMA) embraced an assignment in the 1980s to work with the Centers for Medicare & Medicaid Services (CMS; formerly known as HCFA), and many other payer organizations through a group called the Uniform Claim Form Task Force to standardize and promote the use of a universal health claim form.
Although many providers now submit electronic claims, many of their software/hardware systems depend on the existing 1500 Claim Form in its current image. Minor changes have been made to the form in order to accommodate the National Provider Identifier (NPI) as well as other identifiers.