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CMS Claim Forms

CMS 1500 Forms (formerly HCFA 1500 forms) and UB 04 Forms (formerly UB 92 forms)

CMS 1500 forms are the standardized medical billing forms for professional (non-institutional) medical billing of health insurance claims in the United States.

The current CMS 1500 form version is 08/05, revised by the National Uniform Claim Committee (NUCC) in June 2007 to accommodate updates due to the HIPAA law. The Centers for Medicare and Medicaid Services (CMS) also called the CMS 1500 forms, the appproved OMB-0938-0999 form.

A new CMS 1500 claim form was released by the U.S. Centers for Medicare and Medicaid Services (CMS). The new CMS-1500 (02/12) will replace the current form (08/05).

The updated CMS implementation timeline* for government payments, such as Medicare and Medicaid, is as follows:

January 6, 2014: Medicare begins receiving and processing paper claims submitted on the revised CMS-1500 claim form (02/12)

January 6 - March 31, 2014: Dual-use period during which Medicare continues to receive and process paper claims submitted on either version of the form

April 1, 2014: The current claim form (08/05) is discontinued; Medicare receives and processes paper claims submitted only on the revised CMS-1500 claim form (02/12)

*These dates are tentative and subject to change.

The CMS 1500 forms were formerly HCFA 1500 forms, when CMS was named the Healthcare Financing Administration (HCFA) prior to September 2001.

UB 04 forms are used for institutional medical billing. This includes medical claims produced by hospitals, rehab centers, inpatient psychiatric hospitals, nursing homes and others. The forms were updated by the National Uniform Billing Committee (NUBC) from the prior UB 92 forms. The forms are known officially as CMS 1450 forms.

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