Get the up-to-date Approved OMB-0938-0999 Form CMS-1500 (08-05). Approved OMB-0938-0999 Form CMS-1500 (08-05)-2025 now

Get Form
Approved OMB-0938-0999 Form CMS-1500 (08-05). Approved OMB-0938-0999 Form CMS-1500 (08-05) Preview on Page 1

Here's how it works

01. Edit your form online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send it via email, link, or fax. You can also download it, export it or print it out.

The best way to modify Approved OMB-0938-0999 Form CMS-1500 (08-05). Approved OMB-0938-0999 Form CMS-1500 (08-05) in PDF format online

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2

Working on paperwork with our feature-rich and user-friendly PDF editor is easy. Follow the instructions below to complete Approved OMB-0938-0999 Form CMS-1500 (08-05). Approved OMB-0938-0999 Form CMS-1500 (08-05) online easily and quickly:

  1. Sign in to your account. Log in with your credentials or create a free account to try the product prior to choosing the subscription.
  2. Import a form. Drag and drop the file from your device or import it from other services, like Google Drive, OneDrive, Dropbox, or an external link.
  3. Edit Approved OMB-0938-0999 Form CMS-1500 (08-05). Approved OMB-0938-0999 Form CMS-1500 (08-05). Easily add and underline text, insert pictures, checkmarks, and icons, drop new fillable areas, and rearrange or remove pages from your document.
  4. Get the Approved OMB-0938-0999 Form CMS-1500 (08-05). Approved OMB-0938-0999 Form CMS-1500 (08-05) accomplished. Download your adjusted document, export it to the cloud, print it from the editor, or share it with other participants through a Shareable link or as an email attachment.

Make the most of DocHub, one of the most easy-to-use editors to quickly handle your documentation online!

See more Approved OMB-0938-0999 Form CMS-1500 (08-05). Approved OMB-0938-0999 Form CMS-1500 (08-05) versions

We've got more versions of the Approved OMB-0938-0999 Form CMS-1500 (08-05). Approved OMB-0938-0999 Form CMS-1500 (08-05) form. Select the right Approved OMB-0938-0999 Form CMS-1500 (08-05). Approved OMB-0938-0999 Form CMS-1500 (08-05) version from the list and start editing it straight away!
Versions Form popularity Fillable & printable
2012 4.8 Satisfied (128 Votes)
2005 4 Satisfied (42 Votes)
be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
Contact us
CMS-1500 Claim Form Patient Insured InformationProvider Information Box 4 - Insureds Name Box 17a - Other ID# Box 5 - Patients Address (multiple fields) Box 17b - NPI # Box 6 - Patient Relationship to Insured Box 18 - Hospitalization Dates Related to Current Services23 more rows Mar 5, 2024
The Health Insurance Claim Form (CMS-1500) is used by Allied Health professionals, physicians, laboratories and pharmacies to bill supplies and services to the Medi-Cal program. Providers are required to purchase CMS-1500 claim forms from a vendor.
The Centers for Medicare and Medicaid Services (CMS) provides health coverage to more than 100 million people through Medicare, Medicaid, the Childrens Health Insurance Program, and the Health Insurance Marketplace.
Date of Service on CMS-1500 Billing Overview. Radiology Services. Surgical and Anatomical Pathology. Chronic Care Management. Care Plan Oversight. Home Health Certification and Recertification. Physician End-Stage Renal Disease Services. Transitional Care Management.
The Form CMS-1500 is the standard paper claim form to bill Medicare Fee-For-Service (FFS) Contractors when a paper claim is allowed. In addition to billing Medicare, the 837P and Form CMS-1500 may be suitable for billing various government and some private insurers.
be ready to get more

Complete this form in 5 minutes or less

Get form