Florida workers’ compensation rules require providers to use the correct Division of Workers’ Compensation (DWC) billing form for each type of service.

The following article explains which billing forms apply to different services, where to find them, and instructions on completing the billing forms to avoid payment delays or claim denials.

Key Billing Forms and How to Use Them

The sections below summarize each required Florida DWC billing form and explain how to use them correctly for different provider types and services.

Form DFS-F5-DWC-9 / CMS-1500 Health Insurance Claim Form

Providers must use Form DFS-F5-DWC-9/CMS-1500 for physician and practitioner services. The DWC provides form completion instructions for different types of providers.

Use the table below to select the correct instructions for your provider/service type:

Form DFS-F5-DWC-10 Drugs, Equipment, and Supplies

Providers must use Form DFS-F5-DWC-10 to bill for prescription drugs, medical equipment, and supplies.

Form DFS-F5-DWC-10-A Pharmacy

Providers must use Form DFS-F5-DWC-10-A to bill for prescription drugs, medical equipment, and supplies.

Form DFS-F5-DWC-11 Dental Services

Use this form (ADA Dental Claim Form) to bill for dental treatment and procedures.

daisyBill Solution

Stay up to date on the latest developments in workers’ comp medical billing by subscribing to daisyNews.

SIGN UP FOR DAISYNEWS