New CMS 1500 Claim Form to Replace Old Version April 1

Apr 01, 2014 - Apr 02, 2014


The CMS 1500 claim form is the required format for submitting paper claims to Medicare. Beginning April 1, 2014, CMS will no longer accept paper claims on the old form.

The updated form known as “version 2/12” adds the following functionality:

  • Indicators for differentiating between ICD-9 and ICD-10 diagnosis codes.
  • Expansion of the number of possible diagnosis codes to 12.
  • Qualifiers to identify the following provider roles (on item 17):
  • Ordering
  • Referring
  • Supervising

Resources are available online from the National Uniform Claim Committee, which is charged with maintaining the CMS 1500 claim form