Cms 700 form 2026

1. Click ‘Get Form’ to open the cms 700 form in the editor.
2. Begin by entering the patient’s last name, first name, and middle initial in the designated fields. This information should match what is on the Medicare card.
3. Input the Provider Number issued by Medicare for billing purposes. This is crucial for accurate processing.
4. Fill in the Health Insurance Claim Number (HICN) as shown on the patient's Medicare documentation.
5. Enter the Provider Name and, if applicable, include the Medical Record Number for reference.
6. Specify the Onset Date of the primary diagnosis and Start of Care (SOC) Date to track treatment timelines.
7. Select the type of therapy being billed by checking the appropriate box (e.g., PT, OT, SLP).
8. Document both Primary and Treatment Diagnoses clearly to ensure proper understanding of services rendered.
9. Outline your Plan of Treatment and Functional Goals, detailing short-term goals and expected outcomes.
10. Finally, ensure all required signatures are completed before saving or exporting your filled form for submission.

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