What is an HCFA-1500 form?
The HCFA-1500 (CMS-1500) form and instructions are used by non-institutional providers (physician services) and suppliers to bill Medicare, Part B covered services. It is also used for billing some Medicaid covered services. Critical information must be provided in the appropriate fields to avoid delays or denials of submitted claims. Correct patients name, address, social security and /or identification number, group number, insurance carrier information, physician information, diagnosis and procedure codes, units of service or supply, date and place of service, hospitalization dates applicable to current service, etc. are essential. Several item 24 fields should be completed carefully, e.g., reference numbers in field 24e link ICD-9 codes listed in field 21 to PCT/HCPCS codes listed in fields 24a and 24d. Only one reference number is entered per line item. The claim is submitted on paper or electronically. Physicians are not required to submit claims for all patients but they do eith
