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Bill Instructions: CMS-1500 (HCFA)

Last update
December 5, 2024

The CMS-1500 (HCFA) Form is used by healthcare providers and professionals to file original workers' compensation medical bills in Georgia.

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CMS-1500 (HCFA)

Applicable Services

Filling out the Form

Instructions

Reporting Requirements

Forms & Attachments

Timely Filing

12 months from DOS

CMS-1500 (HCFA) Services

The following table provides a link to the Georgia rule which requires a provider to use the CMS-1500 (HCFA) for each of the following billing purposes.

Service

Rule

Physician Services

Rule 205 (a)

Laboratory / Pathology

DME

Note: the Georgia Medical Fee Schedule is only available after purchase.

CMS-1500 Form Instructions

The state of Georgia requires providers to compliantly complete the CMS-1500 form but provides no further information.

To make things easier for you, daisyBill created this NUCC CMS-1500 Instructions Table showing the requirements of the National Uniform Claim Committee (NUCC), the entity which created and maintains the form. This information is provided for educational purposes only and is not intended to represent state-specific requirements.

For additional information, review the complete NUCC Manual:
1500 Health Insurance Claim Form Reference Instruction Manual for Form Version 02/12

CMS-1500 Required Billing Documentation

For a complete bill, Georgia requires the provider to submit the following supporting documentation with the CMS-1500 Form, when applicable.

Type of CMS-1500 Medical Bill

Required Documents

Treatment

WC-20a

For additional information related to reporting please refer to daisyBill’s Georgia Billing Guide.

Timely Filing

Medical Bills must be filed within 12 months of the date of service for all services rendered in Georgia.

Form

Timely Filing

State Board Workers’ Compensation Rules

Rule

Medical Bills

12 months

Home » Statutes and Rules » Rules

Rule 203 (b)(1)

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