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CMS Claim Forms

CMS 1500 Forms (formerly HCFA 1500 forms)

CMS 1500 08/05 (formerly blank HCFA 1500 forms) laser insurance claim forms and the UB04 insurance claim forms (also called CMS 1450 and formerly UB92 form) are shipping now for your medical billing needs. 

New HCFA 1500 CMS-1500 (Health Insurance Claim Form) APPROVED OMB-0938-0999 FORM CMS-1500 (08-05) NUCC revised the Form CMS-1500. The new 08-05 version of the CMS-1500 form was effective June 29, 2007 and 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. Form CMS-1500 (08-05) replaced the CMS-1500 (12-90) version. Medicare will reject any 12-90 version forms received. 

All Claim Forms ship FREE Priority Mail (2-3 day) delivery. You will not be able to choose a different method in the cart.

 

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  1. CMS-1500 2 Part Claim Forms

    CMS-1500 2 Part Claim Forms

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    CMS2

  2. CMS-1500 Claim Form Window Envelopes

    CMS-1500 Claim Form Window Envelopes

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    1500E

  4. CMS-1500 Laser Claim Forms

    CMS-1500 Laser Claim Forms

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    C-15

  5. UB-04 Laser Claim Forms

    UB-04 Laser Claim Forms

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    UB-04

 
 

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