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CMS-1500 2 Part Claim Forms

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Availability: In stock.

Count Price Qty

CMS-1500 (HCFA) Claim Forms New Version (08/05) 2 part w/c continuous 1000 Count

Price

$69.95

CMS-1500 (HCFA) Claim Forms New Version (08/05) 2 part w/c continuous 500 Count

Price

$39.95

CMS-1500 (HCFA) Claim Forms New Version (08/05) 2 part w/c continuous 250 Count

Price

$29.95

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All Claim Forms Ship via FREE Ground Shipping (delivery in 2-5 business days).

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 via FREE Ground Shipping (delivery in 2-5 business days).

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