Sample claim form 2025

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Black and white copies will be returned as unprocessable. Submission of the CMS 1500 (02/12) claim form should either be typed or computer printed forms. Handwritten forms can cause delays and errors in processing and slow down time for reimbursement.
Can CMS 1500 Forms be Handwritten? While it is technically possible to handwrite a CMS 1500 form, it is generally not recommended.
UB-40 and CMS-1500 are the two most common claim forms for submitting to insurance companies.
Common Mistakes Therapists Make on the CMS-1500 Service coding is inaccurate or not specific enough. Codes were misused. The claim wasnt filed on time. Patient information isnt accurate or is missing. The ICD-10 code is missing or inaccurate. Service provider information missing.
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