Created on January www wpsmedicare com Ordering CMS Claim Forms by ramhood3


									                                                                               Created on January 16, 2008


                        Ordering CMS 1500 Claim Forms
Direct purchases of the CMS National-1500 claim form can be made at any one of the following

NOTE: Effective April 2, 2007, Ambulance providers are responsible for using the CMS 1500 claim

Government Printing Office
Room 3836, Building 3
Washington, DC 20401
(request in writing)

Superintendent of Documents
U.S. Government Printing Office
Washington DC 20402
(202) 512-1800 (pricing desk)

American Medical Association
P. O. Box 10946
Chicago, IL 60610
Attention: Order Department

NOTE: WPS uses Optical Character Recognition (OCR) equipment to process paper claims, therefore,
we are not able to accept black and white copies of the CMS-1500 form. Only the scannable, red-ink
version of the CMS-1500 form can be processed. (These forms are available from the U.S.
Government Printing Office - see addresses above.)


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