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CMS-1500 Health Insurance Claim Forms
for use by Private Practitioners
  • Accommodates reporting of your National Provider Identifier (NPI)

  • Designed for processing on high speed OCR scanning equipment

  • Printed in special red "dropout" ink on 20# paper

  • Available in Laser, Continuous, and Snap-Apart sets

  • Optional pressure-sensitive mailing label available on continuous forms
CMSLC CMSLC CMSLC
ITEM
NUMBER:
FORMS/PACK DESCRIPTION
Laser CMS-1500 Forms:
CMSLC 2500 LASER CUT SHEET
CMSLC1 1000 LASER CUT SHEET
CMSLC500 500 LASER CUT SHEET
CMSLC250 250 LASER CUT SHEET
Continuous CMS-1500 Forms:
CMS1 1000 1-PART CONTINUOUS
CMS2 1000 2-PART CONTINUOUS: WHITE/CANARY
CMSW2 1000 2-PART CONTINUOUS: WHITE/WHITE
CMS3 1000 3-PART CONTINUOUS: WHITE/CANARY/PINK
Continuous CMS-1500 Forms with Labels
CMS1B 1000 1-PART CONTINUOUS
CMS2B 1000 2-PART CONTINUOUS: WHITE/CANARY
Snap-Apart CMS-1500 Forms:
CMSS 1000 2-PART CONTINUOUS: WHITE/CANARY
The Center for Medicare and Medicaid Services (CMS) publishes the Medicare Claims Processing Manual which contains detailed instructions for filling out the CMS-1500 form. The manual is posted on-line as a downloadable PDF file.


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