1500 Claim Form Reference Instruction Manual

The NUCC has developed a 1500 Reference Instruction Manual detailing how to complete the claim form. The purpose of this manual is to help standardize nationally the manner in which the form is being completed.

The current version of the instructions for the 02/12 1500 Claim Form was released in July 2024.
• Version 12.0 7/24 1500 Instruction Manual

DO NOT email completed 1500 Claim Forms to the NUCC. The NUCC does not process claims. Send completed forms to the appropriate payer.

1500 Instruction Manual Changes

The following is a change log of updates that were made to the previous version of the 1500 Instruction Manual, version 11.0 7/23.
• 072024 v11.0 Instruction Manual Change Log

Previous Versions

Previous releases of the Instruction Manual:

• Version 11.0 7/23 1500 Instruction Manual
• Version 10.0 7/22 1500 Instruction Manual
• Version 9.0 7/21 1500 Instruction Manual
• Version 8.0 7/20 1500 Instruction Manual
• Version 7.0 7/19 1500 Instruction Manual
• Version 6.0 7/18 1500 Instruction Manual
• Version 5.0 7/17 1500 Instruction Manual
• Version 4.0 7/16 1500 Instruction Manual
• Version 3.0 7/15 0212 1500 Instruction Manual
• Version 2.0 7/14 0212 1500 Instruction Manual
• Version 1.1 7/13 0212 1500 Instruction Manual

Change Requests

If you would like to request a change for the 1500 Instruction Manual, please complete the following form. The same form can be used to submit requests for changes to the 1500 Claim Form layout. 
• Change Request Form