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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

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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