Printing CMS 1500 Forms from Material Orders

You can preview and print CMS 1500 formsClosed Formerly HCFA. The standard claim form used by a non-institutional provider or supplier to bill Medicare carriers and durable medical equipment regional carriers (DMERCs) when a provider qualifies for a waiver from the Administrative Simplification Compliance Act (ASCA) requirement for electronic submission of claims. It is also used for billing to some Medicaid state agencies. for claims associated with orders.

CMS 1500 form printing is available only for orders with Claim Statuses other than No Insurance, No Claim, Billed to Patient, On Hold, or Void.
  1. On the left side of the Demographics screen, click Material Orders.
  2. Click the Invoiced tab.
  3. Locate the order and select CMS Form from the Print drop-down list.

    4. The CMS 1500 form opens in a new window.

  4. If the form does not open, check to make sure your browser is set to allow pop-up windows. For instructions, see Enabling Pop-ups
  5. Click Print to print the form.