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CMS-1500 (02/12) Claim Form Laser-Cut

The CMS-1500 (02/12) Claim Form Laser-Cut is a single sheet, 8-1/2 x 11 claim form 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  This form is offered in quantities of 25, 50, 100, 250, 500, 1000, & 2500.



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