Advance Beneficiary Notice Forms CMS-R-131, CMS-R-193, and CMS-R-296 -- Outcome and Assessment Information Set (OASIS) Forms -- CMS-216-94, OPO and Histocompatibility Laboratories (HL) Cost Report Form -- CMS-222-92, Independent Rural Health Clinic (RHC)/Freestanding Federally Qualified Health Center (FQHC) Cost Report -- CMS-265-11, Independent End-Stage Renal Disease Cost Report Form -- CMS-276, Prepaid Health Plan Cost Report Form -- CMS-287, Home Office Cost Statement -- CMS-339, Questionnaire for Cost Reporting Forms -- CMS-382, ESRD Beneficiary Selection -- CMS-484, Certificate of Medical Necessity for Oxygen -- CMS-588, Authorization for Electronic Fund Transfer -- CMS-838, Credit Balance Report -- CMS-855 Provider Enrollment Forms -- CMS-1450, Uniform Bill (UB-92 and UB-04) for Inpatient and Outpatient Services -- CMS-1490S, Patient's Request for Medical Payment -- CMS-1500, Health Insurance Claim Form and Physician/Supplier Bill -- CMS-1561 and 1561A, Health Insurance Benefit Agreements -- CMS-1696, Appointment of Representative -- CMS-1728-94, Home Health Agency Cost Report Form -- CMS-1984-99, Hospice Cost Report Form -- CMS-2088-92, Outpatient Rehabilitation Provider Cost Report Form -- CMS-2540-10, SNF Cost Report -- CMS-2540-96 SNF Cost Report -- CMS-2552-96 Hospital Cost Report Form -- CMS-2552-10 Hospital Cost Report Form (2011).
Summary:
CMS Forms are cost reporting forms and other frequently used forms used by Medicare providers. This section does not include every form maintained by CMS but it includes the most commonly used ones. Updated whenever CMS revises a form.
CMS Forms Medicare Billing and Forms Instruction Health Care Registration: Forms, Checklists & Guidelines - Merisalo Hospital Legal Forms, Checklists & Guidelines - Conley Medical Laboratory Management: Forms, Checklists & Guidelines - Conley Medical Staff Management: Forms, Policies, and Procedures for Health Care Providers - Mobley Corporate Governance for Health Care - Model Forms
