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 2021.
• Version 9.0 7/21 1500 Instruction Manual

DO NOT email, fax, or mail 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 8.0 7/20.
• 072021 v.8.0 Instruction Manual Change Log

Previous Versions

Previous releases of the 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. 

Email completed forms to the NUCC at This email address is being protected from spambots. You need JavaScript enabled to view it. (Do NOT use the Change Request Form to ask general instruction questions or request an instruction manual. General questions and requests for instruction manuals can be emailed to the above address.)
• Change Request Form