Cms 1500 form instructions line 33a

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CMS – 1500 Claim Form Description and Instructions. instructions for each field on the service line (24A-J) apply to all six lines. 32. Required. Service Facility Location Information - this should match box 33. 32a. Required. Service Facility Location Information - Enter the NPI of the. Enter the NPI number of the performing provider below the dotted line. If several. Members of the group shown in Item 33 have furnished services, this item is CMS 1500 Claim Form Instructions. 003_FO_CMS1500 Line. ID Qualifier. No. 24J. Rendering Provider ID # (NPI). Situationally provider billed in box 33.The CMS-1500 Form (Health Insurance Claim Form) is sometimes referred to as On the first line enter the street address; the second line, the city and If more than one unlisted procedure code is reported on the claim, precede each description in item 19 with the line item number that corresponds to the line The Center of Medicaid and Medicare Services (CMS) form 1500 must be used to bill SFHP for medical services. The form is used by Physicians and Allied