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CMS-1500 Claim Form Information

The CMS-1500 is the basic form prescribed by CMS for the Medicare program for claims from physicians and suppliers.

CMS-1500 (08-05) Claim Form Completion Instructions

CMS-1500 Form with legend
Modifiers
Alphabetic List of Place of Service Codes
Sources of the CMS-1500 Claim Form
Valid Medicare Card and Suffixes PDF File

Page Last Modified: 08/08/07

Note PDF File: You must have the Adobe Acrobat Reader (version 4.0 or higher) to view the PDF files. If you do not already have this software,  you can Download it here (This software is free!).

 

   
 
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