CMS-1500 PDF - Fillable Form Template
Type, Print, and Save a claim using free Adobe Reader software.
Single User License: Purchase of the CMS-1500 PDF entitles the user to perpetual use of the form, for an unlimited amount of time. A licensed user may open, use, access, display and copy the CMS-1500 PDF on up to two (2) computers. This license and PDF file may not be shared, transferred or used by others.
The revised CMS-1500 (version 02/12) is the universal claim form for all payers (not just Medicare) to receive and process claims. The newly revised form now allows for ICD-10 reporting, and brings uniformity with current electronic health care claims requirements.
Posted by Unknown on 9th May 2014
Very good solution for me when changing to the newer CMS-1500 Form became mandatory and my billing program was not updatable. Easy to use.
Posted by Unknown on 14th Apr 2014
I was able to easily create templates for printing non-par Medicare submissions on blank CMS-1500 forms. Simple and slick.