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CMS 1500 Claim Forms For Pinfeed Printers Version 02/12

NOTICE:  As of June 30, 2016 the OMB Number 0938-1197 on the CMS-1500 form dated (02/12) has expired.  This is a standard practice within the Government Agency, Office of Management and Budget (OMB). The agency is currently in the process of extending the OMB number 0938-1197 with a new date of (09/19) within their internal departments. No changes to the forms fields have been made, however the date change at the top and bottom of the from has been updated from (02/12) to (09/19).
 
These are the CMS 1500 forms version 02/12, for pinfeed printers (otherwise known as continuous)
 

The Centers for Medicare & Medicaid Services (CMS) approved a CMS-1500 form (02/12) to replace the previous form (08/05). Fully updated with the latest revisions, the CMS-1500 form is 100% compliant and printed to exact specifications for layout, paper and ink.

 
The transition period for switching to the new form has passed. As of April 1, 2014, the old claim form (08/05) was discontinued and all private insurance carriers and Medicare began receiving and processing paper claims submitted only on the revised CMS-1500 claim form (02/12).

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Available in 1, 2 or 3 parts for pinfeed printers.
Simply click on the link below for more information or to order pinfeed compatible CMS 1500 claim forms. Select the quantity and shipping options you need, and order! Want samples mailed to you? Click Here.

We make ordering CMS 1500 forms for pinfeed printers easy.

  • 24 Hour Turnaround
  • Instant Online Pricing 
  • UPS Ground To Most States In 3 Days Or Less 
  • Discounts For More Than 1 Carton Purchases (or Pack) 
  • 100% compliant with the approved update to the HCFA 1500 health claim form 
  • Contains Approved OMB-0938-1197 FORM CMS 1500 (02/12) on the bottom of the form 
  • The arrow at the top right of the form measures 1/4" from the top of the form, as required 
  • Approved by the NUCC

CMS 1500 forms (02/12) for your pinfeed printer are shipped in sturdy cartons. These sturdy cartons include a traditional flap lid that can be closed after use, protecting the forms inside between use. The maximum number of forms in a carton depends on the number of parts you choose. Please see the individual 1, 2 or 3 part for pinfeed printers product page.

The CMS 1500 form in the pinfeed printer version is compatible with the vast majority of pinfeed printers. The paper used in the pinfeed printer version of the CMS 1500 claim form is a special paper. If you use traditional blank white printer paper, your CMS 1500 forms might not scan correctly when processed by insurance carriers. Incorrect scans can and do result in delayed or denied payments to you and to your patients. We urge you to order your CMS 1500 forms with our special scan-approved paper that we use on every carton of CMS 1500 forms. Our forms are printed on special OCR (optical character recognition) paper to ensure the highest possible degree of scanning accuracy.

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