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 Medical/Mental Health Billing on 18th Jun 2014
On screen data entry line by line. No annoying pop up windows. Can save document for continued biller and company info. Easy use/immediate usage after download. Program can adjust to old and new 1500 form. Text information input prints out on original 1500 with "text only" printing feature. Perfect for small or larger company.
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.