The CMS -1500 PDF is ideal for submitting the standard paper claim to bill for services. Type, Print, Save & Edit a CMS-1500 with Adobe Reader software.
Try out the usable demos below.
Prints Form & Typed Text Prints Text Only (for Pre-Printed Forms)
Save the Demo files to your Mac, then open the PDF with Adobe Reader, not Mac Preview, to use the form features.
Over 3500 satisfied customers using the CMS-1500 PDF
Click for screenshot
User Highlights
• Use Adobe Reader to type in the fillable form, and save each claim as a PDF file
Optional Form Calculations: Automatically adds up the charges and totals for you. Calculation 1 adds charges 1-6 in Box 24F for Box 28 (Total Charge).
• Has the exact specifications of the NUCC CMS-1500 (08/05) paper claim
• Data Fields highlighted in blue for easy recognition
• Helpful field call outs to assist user in filling in the form
Save unlimited claims/templates to your computer! One-time fee!
• Print Red "dropout" ink* & black type on plain paper or
• Print “type only” for use with Comercially Printed CMS-1500 Paper Claims
Receive both print options with purchase.
Calculation 2 multiplies ( Box 24F times 24G) then adds charges 1-6 to Box 28.
*Note -. It may not be possible to replicate the form color (OCR Red, Flint J-6983)
with your printer. We recommend sending a sample first, or print "text only" into a
Pre-printed CMS-1500 Paper Claim to ensure your claim is accepted and processed.
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