US · guidance
CMS Pub. 100-04, ch. 10, § 40
Completion of Form CMS-1450 for Home Health Agency Billing
The Social Security Act at §1862 (a)(22) requires that all claims for Medicare payment
must be submitted in an electronic form specified by the Secretary of Health and Human
Services, unless an exception described at §1862 (h) applies. The electronic form
required for billing home health services is the ASC X12 837 institutional claim
transaction. Since the data structure of the 837 transaction is difficult to express in
narrative form and to provide assistance to small providers excepted from the electronic
claim requirement, the instructions below are given relative to the data element names on
the Form CMS-1450 hardcopy form. Each data element name is shown in bold type.
Information regarding the form locator numbers that correspond to these data element
names is found in chapter 25.
Because claim formats serve the needs of many payers, some data elements may not be
needed by a particular payer. This section provides detailed information only for items
required for Medicare home health claims. Items not listed need not be completed
although home health agencies may complete them when billing multiple payers. In all
cases, the provider is responsible for filing a timely claim for payment. (See chapter 1.)
History
(Rev. 3021, Issued: 08-08-14, Effective: 01-01-12, Implementation: 09-08-14)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
a84949418f02b89d11c8c2f6dc1e825115bb3f031f0d9ebc2bcfbc6dccfc142f
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