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)
Mac & WIndows Compatible
Over 3500 satisfied customers using the CMS-1500 PDF
Click for screenshot
• Use Adobe Reader to type in the fillable form, and save each claim as a PDF fileOptional Form Calculations: Automatically adds up the charges and totals for you.
• 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 1 adds charges 1-6 in Box 24F for Box 28 (Total Charge).
Calculation 2 multiplies ( Box 24F times 24G) then adds charges 1-6 to Box 28.
Receive both calculation options with purchase.
*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.