# Online Fillable HCFA 1500 form



## tlm5506 (Mar 15, 2014)

Hello.
Hopefully I'm posting this in the correct location, but does anyone know of a reliable online sight that has a fillable 1500 form? I did some of my own searching and didn't come up with much. I have my own official HCFA forms, so I'm looking for a sight that will let me enter in the data and then I can print it off on my forms. Some of the sights I came across are expensive, so I'm looking for a not-so-expensive alternative. I'm looking for the 08/05 fillable HCFA online form. Any help would be appreciated.
Thanks.


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## mitchellde (Mar 15, 2014)

I do not know of any that do not come attached with expensive billing software, however after April 1 the 2/12 version will be the only acceptable one for paper submission.


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## tlm5506 (Mar 15, 2014)

Thanks for responding.
I am processing work comp claims, so that is why I mentioned the 08/05 forms. Does anyone know if work comp insurance must accept the 2/12 forms? I know they are not mandated to switch to ICD-10.


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## Nancy00 (Mar 16, 2014)

*Work Comp and the new CMS 1500 billing form*

To my knowledge, Texas workers comp will continue to use the old CMS 1500 form until the legislature determines that they must convert to the new 02/12form. I am not familiar with other state requirements so I would suggest you checking with your state.


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## MarcusM (Mar 17, 2014)

The Texas Department of Insurance, Division of Workers’ Compensation (Division) adopts amendments to ?133.10, concerning required billing forms and formats.
This section is adopted with changes to the proposed text published in the October 11, 2013, issue of the Texas Register (38 TexReg 6999). In the October 18, 2013, issue of the Texas Register (38 TexReg 7334), a notice of correction revises the implementation from “April 1, 2013" to "April 1, 2014."

Section 133.10 addresses Required Billing Forms and Formats. The amendment to ?133.10(b) changes the form requirement for medical bills filed or resubmitted for professional and noninstitutional services from 1500 Health Insurance Claim form Version 08/05 (CMS-1500) to the updated 02/12 (CMS-1500) and is necessary to comply with Labor Code ?413.011(a).This section is effective for medical bills submitted on or after April 1, 2014.
8. CERTIFICATION.
This agency hereby certifies that the adopted amendments have been reviewed by legal counsel and found to be within the agency’s authority to adopt.
Issued at Austin, Texas, on December 16, 2013.


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