The CMS 1500 form filler that flags the 23 most common errors before your clearinghouse rejects them. Built for solo billers and small clinics.
$19/mo solo · $49/mo for clinics up to 5 users
Stop submitting claims that bounce on Box 17b or a missing taxonomy code.
NPI checksums, ICD-10 syntax, CPT/HCPCS, place-of-service codes, modifier pairs, DX pointer ranges. Errors highlight in real time.
23 named rules: missing referring NPI when Box 17 is set, mismatched insured DOB, invalid POS for telehealth, DX pointers without diagnoses.
Pixel-aligned to the OMB-approved CMS-1500 (02/12) red-ink form. Print, fax, or attach to your payer portal.
One-click export to ANSI X12 837P. Upload directly to Availity, Change Healthcare, Office Ally, or your clearinghouse of choice.
No per-claim fees. No setup. Cancel anytime.
$19/mo
$49/mo
The CMS-1500 (formerly HCFA-1500) is the standard paper claim form used by non-institutional healthcare providers — physicians, therapists, chiropractors, solo billers — to bill Medicare, Medicaid, and most commercial payers. The current version is CMS-1500 (02/12).
CMS-1500 is for individual providers and non-institutional practices. UB-04 (CMS-1450) is for institutional providers — hospitals, nursing facilities, hospice. If you bill as an individual NPI for office or outpatient services, you use CMS-1500.
A CMS-1500 has 33 fields. Boxes 1–13 cover patient and insured info, 14–23 cover the condition and authorizations, 24 holds up to 6 service lines (date, place of service, CPT/HCPCS, diagnosis pointer, charge, units, rendering NPI), and 25–33 cover billing provider info and signatures. CMS1500.app validates each box as you type.
Yes. CMS1500.app converts your CMS-1500 to the 837P electronic format accepted by clearinghouses (Availity, Change Healthcare, Office Ally). You can also export a payer-ready PDF for paper submission.
Yes. HCFA-1500 was renamed CMS-1500 in 2001 when the Health Care Financing Administration became the Centers for Medicare & Medicaid Services. Some payers and billing veterans still call it "HCFA."
14-day trial. No credit card. Fill your first 10 claims on us.