Changes to the 1500 Claim Form

The National Uniform Claim Committee has developed and approved a new version of the HCFA 1500 claim form so that it is fully in line with the 5010 Standards and can accommodate the new ICD-10 code set. While the NUCC has been working on this new claim form since 2009, it received official approval in June, 2013.

The key dates for transitioning to the Updated Form are as follows:

  • January 6, 2014: Payers begin receiving and processing paper claims submitted on the revised 1500 Claim Form (version 02/12).
  • January 6 through March 31, 2014: Dual use period during which payers continue to receive and process paper claims submitted on the old 1500 Claim Form (version 08/05).
  • April 1, 2014: Payers receive and process paper claims submitted only on the revised 1500 Claim Form (version 02/12).

For a detailed explanation of each change on the version 02/12 1500 Claim Form, the NUCC has published a detailed presentation on its website.

An image of the CMS 1500 version 02/12 claim form:

NEW CMS 1500 claim form version 2012_02