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US · guidance

CMS Pub. 100-04, ch. 1, § 02.2.1

Paper Formats for Institutional Claims

activein force · 2026-08-25 – presentas-observed

The required format for submitting institutional claims to Medicare on paper is the CMS-

1450 form. Refer to chapter 25 for more information, including how to complete this

form. In addition, where needed, additional instruction is provided throughout this

manual for submitting paper claims.

History

(Rev. 3086, Issued: 10-03-14, Effective: ICD-10: Upon Implementation of ICD-10, ASC X12: January 1, 2012, Implementation ICD-10: Upon Implementation of ICD- 10; ASC X12: November 4, 2014)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
6d74645f1907d42b269075c71a904520d4aac415c7821a4fd09ee8040ade0ffc
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