Form CMS-1500, Health Insurance Claim Form
The CMS-1500 is the standard paper claim form professional providers use to bill Medicare and most other insurers. Download the official PDF or open it in the editor.
This is the genuine CMS PDF, unmodified. Source: CMS official page.
What is CMS-1500?
Form CMS-1500 is the standard claim form for non-institutional health care providers and suppliers: physicians, therapists, labs, and ambulance services billing Medicare Part B and most commercial insurers on paper. It carries the patient, insured, diagnosis codes, service lines with CPT/HCPCS codes, and billing provider details, and it is maintained by the National Uniform Claim Committee.
Paper claims to Medicare must be submitted on the official printed version with red dropout ink so scanners can read them; most providers bill electronically with the 837P transaction instead, and Medicare requires electronic claims unless a provider qualifies for a waiver.
Who files CMS-1500?
- Physicians and other professional providers billing on paper where permitted
- Suppliers and small practices with an ASCA waiver from mandatory electronic billing
- Patients occasionally, when filing directly with a commercial insurer that accepts it
How to fill out CMS-1500
- Complete the patient and insured blocks (items 1 to 13) from the insurance card and intake details.
- Enter diagnosis codes in item 21 and link each service line to them.
- List services in item 24: dates, place of service, CPT/HCPCS codes, charges, and units.
- Complete the billing provider blocks (items 25 to 33) including NPI numbers.
- Print onto the official red-ink form stock for paper submission, or use the layout as a reference while billing electronically.
Get CMS-1500
CMS publishes CMS-1500 as a flat PDF with no built-in form fields, so there is no quick-fill form here. Open it in the editor to type directly onto the pages, tick boxes and sign, or download the official blank and complete it in your PDF reader or by hand.
Frequently asked questions
Can I print this PDF and mail it to Medicare?
No. Medicare and most payers scan paper claims and require the official red dropout-ink form stock; a black-and-white printout is rejected. Order official stock or bill electronically.
What is the electronic equivalent?
The 837P professional claim transaction. Medicare requires electronic submission for most providers under ASCA, with limited waiver exceptions.