What is an HCFA 1500 Form?

A Form CMS 1500 is filed to initiate a Medicare claim.

The Form CMS-1500, previously called an HCFA 1500 Form, is a form used in the health care industry to make Medicare claims. Health care providers or their billing agents complete the form and submit it to the applicable Medicare carriers or Medicare contractors.

The Form

Medicare requires either the Form CMS-1500 or an electronic filing before claims are considered. The electronic system is required for most claims. Exceptions that allow the Form CMS-1500 include small providers with less than 10 full time employees, and those who file fewer than 10 claims each month.

Completion

It is illegal to charge patients a fee to complete Form CMS-1500 or other Medicare claims. The forms must be completed in black ink or typed, and some medical coding knowledge is necessary.

Time Frame

All Medicare claims must be submitted within a year of the service or treatment to be paid. If a Form CMS-1500 is not completed completely or is completed incorrectly, it may be returned. The original, one-year deadline applies to resubmissions as well.

References

• California Victim Compensation and Government Claims Board: CMS (HCFA) FORM 1500 QUESTIONS AND ANSWERS
• Centers for Medicare and Medicaid Services: CMS-1500 At a Glance
• Centers for Medicare and Medicaid Services: Administrative Simplification Compliance Act