CMS-1500 Claim Forms
Purchase or download? Some considerations.

CMS-1500 (formerly HCFA-1500) claim forms may be purchased or downloaded free of charge and printed. For most users, the first option will be the most cost-effective and the most reliable.

Forms may be purchased directly from the U.S. Government Printing Office, but are available at discounted prices from third party vendors. At $35.00 for a case of 2,500 single sheet forms (from one vendor), that's less than 1.5 cents per page. The cost of printing a CMS-1500 form on an ink jet printer could easily be four times that much or more, not to mention the cost of premature printer failure due to large volume printing.

Although it is more economical to buy forms by the case, they may be purchased in packages of 500 and 100.

Print-ready PDF copies may be downloaded free of charge, but beware. The PDF copy may not exactly match the original, and unless the printed copy matches the original exactly in scale, font and even ink color, it may, and probably will be, rejected. The following is a cautionary statement from CMS:

"The National Uniform Claim Committee (NUCC) is responsible for the design and maintenance of the CMS-1500 form. CMS does not supply the form to providers for claim submission. In order to purchase claim forms, you should contact the U.S. Government Printing Office at (202) 512-1800, local printing companies in your area, and/or office supply stores."

"The only acceptable claim forms are those printed in Flint OCR Red, J6983, (or exact match) ink. Although a copy of the CMS-1500 form can be downloaded, copies of the form cannot be used for submission of claims, since your copy may not accurately replicate the scale and OCR color of the form. The majority of paper claims sent to carriers and DMERCs are scanned using Optical Character Recognition (OCR) technology. This scanning technology allows for the data contents contained on the form to be read while the actual form fields, headings, and lines remain invisible to the scanner. Photocopies cannot be scanned and therefore are not accepted by all carriers and DMERCs." Source: http://www.cms.hhs.gov/electronicbillingeditrans/16_1500.asp

This would seem to apply to CMS-1500 claim form printing programs, as well.

For more information, see 1500 Claim Form FAQs: http://www.nucc.org/index.php

Forms may be ordered from numerous vendors (Google 'CMS-1500 forms') or from the Government Printing Office:

US Government Printing Office
Superintendent of Documents
Washington, DC 20402
(866) 512-1800
(202) 512-1800 (Pricing Desk)
(202) 512-2250 (Fax)

GPO Bookstore
http://bookstore.gpo.gov/subjects/sb-294.jsp

Also, remember that the (12/90) version of the CMS-1500 form has been discontinued; only the revised (08/05) form is acceptable.

A PDF copy of the revised CMS-1500 form is available online from NUCC at http://www.nucc.org/images/stories/PDF/final_1500_claim_form.pdf.

The file contains three different versions of the same 1500 form: one in standard format, one in grid format and one in template format. Remember, as noted above, that the PDF file may not print to exact specifications. Print specifications are available in Appendix A of the NUCC instruction manual at http://www.nucc.org/images/stories/PDF/claim_form_manual_v1-3_7-06.pdf

W. E. Benet, Ph.D., Psy.D.
AssessmentPsychology.com
December 30, 2008