Credentialing Glossary
CMS-1500
billingDefinition
Standard paper claim form for professional (non-facility) billing. Maintained by NUCC. 33 fields including patient demographics (1-13), provider information (14-17, 24, 31-33), and service line detail (24A-24J for date of service, POS, CPT, modifier, diagnosis pointer, charges, units, NPI). Electronic equivalent is the 837P transaction. Almost all commercial and Medicare claims now go through the 837P; paper CMS-1500 is rare except for some Medicaid plans.