CMS 1500 — Professional Claim
HCFA-1500Form fields follow the official CMS 1500 (02-12) claim format
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A
Boxes 1–13 — Patient & Insured Information
Box 1 Insurance Type
1a Insured's ID Number
2 Patient's Name (Last, First, MI)
3 Patient DOB / Sex
4 Insured's Name (if different)
5 Patient's Address
6 Patient Relationship to Insured
7 Insured's Address
8 Patient Status
9 Other Insured's Name (Secondary Coverage)
10 Is Patient's Condition Related To:
11 Insured's Policy Group / FECA #
12 Patient's Signature Date
13 Insured's Authorization Signature
B
Boxes 14–23 — Condition Information
14 Date of Current Illness / Injury
15 Other Date (if applicable)
16 Dates Patient Unable to Work
17 Referring Provider Name & NPI
17a/b Referring NPI
18 Hospitalization Dates
19 Additional Claim Information
20 Outside Lab? / 21 Diagnosis Codes (ICD-10)
22 Resubmission Code / Original Ref #
23 Prior Authorization Number
C
Box 24 — Service Lines (A–J)
| # | A. Date From | A. Date To | B. POS | C. EMG | D. CPT/HCPCS | D. Modifier | E. Diag Ptr | F. Charges | G. Units | H. EPSDT | I. ID Qual | J. NPI |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | ||||||||||||
| 2 | ||||||||||||
| 3 |
D
Boxes 25–33 — Provider & Billing Information
25 Federal Tax ID (EIN/SSN)
26 Patient Account #
27 Accept Assignment?
28 Total Charge
29 Amount Paid
30 Reserved for NUCC Use
31 Signature of Physician
31 Date Signed
32 Service Facility Name & Address
32a Service Facility NPI
32b Other ID
33 Billing Provider Name & Address
33a Billing Provider NPI
33b Other Provider ID
Total Charges:
$470.00
Lines: 2 of 6