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CMS-1500 (02/12) 1-Part & 2-Part Continuous

The CMS-1500 (02/12) Claim Form 1-Part & 2-Part Continuous forms are used with pin-fed/continuous style printers. The CMS-1500 (02/12) 2-Part Snap-Apart forms are used for hand-written or typed claims. The CMS-1500 form is for use by all medical facilities. Per federal regulations, all healthcare providers must use the CMS-1500 Healthcare Claim Form for specific types of billing. The CMS-1500 accommodates reporting of the National Provider Identifier, which must be used by all HIPAA-covered entities.


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