Bill Instructions: CMS-1500 (HCFA)
The CMS-1500 (HCFA) Form is used by healthcare providers and professionals to file original workers' compensation medical bills in Virginia.
Article Contents |
Navigation Link |
CMS-1500 (HCFA) |
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Filling out the Form |
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Reporting Requirements |
CMS-1500 (HCFA) Services
The following table provides a link to the Virginia regulations/rules which require a provider to use the CMS-1500 (HCFA) for billing purposes.
Service |
Rules |
Physician Services |
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Anesthesia | |
Radiology | |
Laboratory / Pathology | |
Evaluation and Management |
CMS-1500 Form Instructions
The state of Virginia has no specific requirements for any billing forms. It is recommended that providers compliantly complete the CMS-1500 Form but no specifications are provided.
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, Virginia requires the provider to submit the following supporting documentation with the CMS-1500 Form, when applicable.
CMS-1500 Medical Bill |
Recommended Documents |
Treatment |
Chart notes |
Surgery |
Operative report / notes |
Radiology |
Radiology report / notes |
Laboratory |
Test results / notes |
Diagnostic Testing |
Test results / notes |
For additional information related to reporting please refer to daisyBill’s Virginia Billing Guide.
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