All forms are government approved CMS-1500 to serve federal programs and private insurers as a universal claim form
Approved OMB-0938-1197 (02/12).
1 Part Laser (25 Single Sheets - for Laser/Inkjet Printers). 02/12 Version.......... Both CMS and the NUCC have issued their transition timelines, affecting providers that accept government and private insurance. Please check with your Payer / Insurance Companies