Avoid Returned Paper Claims

Submit with the current CMS-1500 form (version 02/12)

June 10, 2015 - Beginning August 1, 2015, all paper claims for medical services must be submitted on the CMS-1500 form (version 02/12). Claims received on any other version of the form will be returned with the following message:

“Charges must be submitted on the CMS-1500 form version 02/12.”

The current CMS-1500 (02/12) form supports the ICD-10 diagnosis code set, which is required to be used beginning Oct. 1, 2015. More information regarding our ICD-10 transition and how to prepare is available at www.carefirst.com/icd10.

You may order a supply of the CMS 1500 (02/12) form through your normal process. For a sample of the form, visit www.carefirst.com/providerforms and download the PDF, located under Administrative Forms.

Save Time (and Money).

CareFirst encourages the submission of claims electronically to avoid returned claims. Visit www.carefirst.com/electronicclaims to learn more.