Download the CMS-1500 claim form (free PDF)
The current CMS-1500 (version 02/12) is the standard paper claim form used by physicians and other non-institutional providers to bill Medicare Part B, Medicaid and most commercial payers. This is the official form as published by the Centers for Medicare & Medicaid Services, free to download and fill in on screen.
Before you print it: a claim submitted on paper has to be on the official form printed in the special drop-out red ink, which scanners are built to ignore. A version printed on a normal black-and-white printer will be rejected, so the PDF above is for reference, for completing electronically, and for checking field positions — buy the pre-printed stock from the U.S. Government Bookstore or an authorised supplier when you need to file on paper.
Processing these by hand? See how CMS-1500 OCR reads a completed form and exports it straight to 837P EDI.
What has changed since 2018 — and what hasn’t
The form itself has not changed. The current CMS-1500 is still version 02/12, the revision introduced in 2014. If you hold pre-printed stock marked 02/12 it is still the current form, and the field layout above is still accurate.
The instructions are reissued every July. The form is stable but the guidance for completing it is not: the National Uniform Claim Committee publishes the 1500 Health Insurance Claim Form Reference Instruction Manual and releases a new version each July, with a change log against the previous one. Version 13.0 (7/25) was current when this page was last reviewed.
Telehealth changed how box 24B is completed. Two place-of-service codes now separate telehealth by where the patient was: POS 02 for telehealth provided somewhere other than the patient’s home, and POS 10 for telehealth provided in the patient’s home. This is not just a reporting distinction — since 1 January 2024 Medicare pays POS 10 at the non-facility rate, which is higher than the facility rate applied to POS 02, so the wrong code costs money rather than triggering a rejection. Many payers also expect modifier 95 on synchronous telehealth lines.
Diagnosis coding turns over every October. ICD-10-CM revisions take effect on 1 October each year. The codes in box 21 and the pointers in box 24E have to match the code set in force on the date of service, not the date the claim is keyed, which is a common source of denials on claims entered late.
For anyone capturing these forms automatically, the stability of the form is the useful part: a template built against 02/12 keeps working. What has to be maintained is the validation behind it — the place-of-service list, the current ICD-10 set, and the 837P rules the data is exported into.
Last reviewed September 2026 against the form published by CMS and the current NUCC instruction manual.
We continuously development and improve our forms solution to provide better recognition accuracy, data validation and integration with other solutions. For our CMS-1500 there have been substantial improvements to the OCR accuracy made for both Black and White as well as Color Drop-Out versions of the CMS-1500 form, as well as combining them into a single input stream for easier management.
The color drop-out template has been improved to allow for significant variations in the fonts, text alignment, and capture of fields when the form is filled in “unconventionally”.
Data validations have also been improved to enforce full compliance with the 837P EDI format.
The CMS 1500 (formerly HCFA 1500) is the standard paper claim medical form used by non-institutional healthcare providers, such as private practices, to submit a claim for billing Medicare Fee-For-Service (FFS) Contractors for Part B covered services and some Medicaid-covered services. The CMS 1500 is sometimes also suitable for billing various government and some private insurers and is accepted by most health insurance providers. The CMS 1500 has been updated to include National Provider Identifiers (NPIs), or unique numbers required by HIPAA and contains all the basic information needed to submit an accurate claim. Before a claim is submitted, a number of technical protocols and industry standards must be met for insurance claims to be delivered expediently and accurately between medical practice and payer.
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