CMS 1500 billing guide
• Complete a separate claim form for each member to whom services were provided.
• Type or print all applicable information (as stated in the instructions) on the claim form, using
black ink only. Be sure all entries are complete, accurate, and legible.
• For each claim line, enter all required information as applicable, repeating if necessary. Do not use
ditto marks or words such as “same as above.”
• Attach any necessary reports or required forms to the claim form.
• When a required entry is a date, enter the date in MMDDYY or MMDDYYYY format.
Example: For a member born on February 28, 1960, the entry would be as follows: 02281960.
Time Limitations on the Submission of Claims
Claims must be received by MassHealth within 90 days from the date of service or the date of the
explanation of benefits from another insurer. For additional information about the deadlines for
submitting claims, please see MassHealth billing regulations (beginning at 130 CMR 450.309).
• Complete a separate claim form for each member to whom services were provided.
• Type or print all applicable information (as stated in the instructions) on the claim form, using
black ink only. Be sure all entries are complete, accurate, and legible.
• For each claim line, enter all required information as applicable, repeating if necessary. Do not use
ditto marks or words such as “same as above.”
• Attach any necessary reports or required forms to the claim form.
• When a required entry is a date, enter the date in MMDDYY or MMDDYYYY format.
Example: For a member born on February 28, 1960, the entry would be as follows: 02281960.
Time Limitations on the Submission of Claims
Claims must be received by MassHealth within 90 days from the date of service or the date of the
explanation of benefits from another insurer. For additional information about the deadlines for
submitting claims, please see MassHealth billing regulations (beginning at 130 CMR 450.309).