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Bill Instructions: CMS-1500 (HCFA)

Last update
June 14, 2019

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

Article Contents

Navigation Link

Filling out the Form

Instructions

Required Reports

Forms & Attachments

CMS-1500 Form Instructions

The state of New Jersey has no specific requirements for any billing forms. It is recommended that providers compliantly complete the CMS-1500 Form.

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 Billing Documentation

For a complete bill, the provider should consider submitting the following supporting documentation with the CMS-1500 Form when applicable.

CMS-1500 Medical Bill

Recommended Documents

Treatment

Recommend attaching chart notes.

Surgery

Operative Report

Radiology

Radiology Report if billing for Professional Component

Laboratory

Test Results Report

Diagnostic Testing

Test Results Report

For additional information related to reporting please refer to DaisyBill’s New Jersey Billing Guide.

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