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Changes to CMS-1500 (HCFA) Form

Both CMS 1500 (HCFA) forms available now!
A new CMS 1500 claim form was released by the U.S. Centers for Medicare and Medicaid Services (CMS) on June 17, 2013. The new CMS 1500 (02/12) will replace the current form (08/05).

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Please take note of these dates for transitioning to the new (02/12) form:
January 6, 2014: Private insurance carriers and Medicare begin receiving and processing paper claims submitted on the revised CMS-1500 claim form (02/12).
January 6 – March 31, 2014: Dual-use period during which private insurance carriers and Medicare continue to receive and process paper claims submitted on either version of the form.
April 1, 2014: The current claim form (08/05) is discontinued; all private insurance carriers and Medicare receives and processes paper claims submitted only on the revised CMS-1500 claim form (02/12).

Providers should check with their payers and/or clearinghouses to determine when they will begin to accept the revised forms.

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