Experience. Integrity. Advocacy.
Experience. Integrity. Advocacy.

New Claim Form 1500 Coming Soon . . . Maybe?

The updated CMS 1500 claim form must be approved soon by the Centers for Medicare and Medicaid Services (CMS) if the recommended timeline by the National Uniform Claim Committee (NUCC) will stand.


The changes to the paper claim form were recommended by the NUCC in June 2011 to accommodate data reporting changes to the version 5010 837 electronic claims formats. A draft form known as the “02/12 Revised 1500 Claim Form” was submitted to CMS and underwent a 60-day comment period which closed July 30, 2012. An additional 30-day comment period with the Office of Management and Budget (OMB) ended on October 22, 2012. With information collected from those comment periods, the revised form is still being reviewed at CMS.

Along with the changes, the NUCC recommended that the new form begin to be used on June 1, 2013, concurrently with the current 08/05 1500 Claim Form. Under that recommendation, both forms would continue to be accepted until October 1, 2013, when only the revised form would be used. Those dates may be adjusted once the new form is approved by CMS since the June 1, 2013, date is just two weeks away, and since the deadline for the implementation of ICD-10 has been postponed until October 1, 2014. The new electronic and paper claims formats were made, in part, to accommodate that code set change.

The changes to the form were defined as “minor changes” since no alterations were made to the existing lines or underlying format. All changes happened within the current form fields and consisted primarily of adding, deleting, or changing the labels and/or use of the fields.


Most notable among the change were the addition of eight additional slots for diagnosis codes, so that the paper claim form, like the electronic claims, is able to accommodate a total of twelve diagnoses. Also, the form contains an indicator slot so that providers can acknowledge whether they are using ICD-9 or ICD-10 codes. A list of all changes in the 02/12 Revised 1500 Claim Form is available at the NUCC website.

Instructions for using the current 08/05 1500 Claim Form also are available at the NUCC website.

(To  see larger versions of the current and revised 1500 claims forms, click on the thumbnails within the article.)

Visit the CIPROMS News and Events regularly for more information about when the new claim form is approved and implemented. Or, sign up for our regular CIPROMS newsletter to get that information delivered to your inbox.

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Charity Singleton Craig

Charity Singleton Craig is a freelance writer and editor who provides communications and marketing services for CIPROMS. She is responsible for creating, editing, and managing all content, design, and interaction on the company website and social media channels in order to promote CIPROMS as a thought leader in healthcare billing and management.

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