1500 Claim Form Renewed by OMB

October 21, 2020

The Office of Management and Budget (OMB) has completed its review and renewed the 1500 claim form for use by government programs, most notably Medicare.  The form has been renewed in its current format, with no changes to the OMB number, data fields, or other text on the form.

Forms with the 02/12 NUCC approval date and OMB number 0938-1197 (02-12) remain in effect and valid.

The renewal of the 1500 claim form by OMB occurs every three years and is outside the scope of the NUCC's work.