Centers for Medicare & Medicaid Services (CMS) Forms
The Centers for Medicare & Medicaid Services (CMS) is a U.S. federal agency associated by name with Medicare and Medicaid, the two program areas that anchor many forms represented here.
The collection includes Medicare Part B enrollment and coverage-termination requests, employment-information forms, and a participating physician or supplier agreement. Other listed documents address clinical laboratory certification, health insurance claims, and Freedom of Information Act requests. These titles span coverage-related paperwork and distinct healthcare and administrative topics.
Centers for Medicare & Medicaid Services (CMS) forms
- CMS-116 · CMSForm CMS-116, Clinical Laboratory Improvement Amendments Of 1988 (Clia) Application For Certification
Form CMS-116 is the CLIA Application for Certification issued by the Centers for Medicare & Medicaid Services (CMS) for laboratories that test human specimens. Fill out the form online on FillingPDF and download or print the completed PDF.
10 pages - CMS-1500 · CMSForm CMS-1500, Health Insurance Claim Form
The CMS-1500 Health Insurance Claim Form is the paper claim form published by the Centers for Medicare & Medicaid Services (CMS) and approved by the NUCC. Fill it out online on FillingPDF and download or print the completed PDF.
4 pages - CMS-1763 · CMSForm CMS-1763, Request for Termination of Premium Hospital Insurance of Supplementary Medical Insurance
Form CMS-1763 is the Centers for Medicare & Medicaid Services (CMS) request to end Medicare premium Part A, Part B or Part B-ID coverage. Fill it out online on FillingPDF and download or print the completed PDF.
2 pages - CMSForm CMS-1763, Request for Termination of Premium Part A, Part B, or Part B Immunosuppressive Drug Coverage
CMS-1763 is the CMS form for asking Social Security to end Medicare Part A (when you pay a premium for it), Part B or Part B-ID coverage. Fill it out online on FillingPDF and download or print the completed PDF.
2 pages - CMS-40B · CMSForm CMS-40B, Request for Enrollment in Medicare Part B (Medical Insurance)
CMS-40B is the CMS form for enrolling in Medicare Part B (Medical Insurance) if you already have Part A. Fill it out online on FillingPDF and download or print the completed PDF to send to Social Security.
3 pages - CMS-460 · CMSForm CMS-460, Medicare Participating Physician Or Supplier Agreement
Form CMS-460 is the Medicare Participating Physician or Supplier Agreement issued by CMS. Fill out the fillable PDF online on FillingPDF and download or print it to send to your Medicare Administrative Contractor (MAC).
3 pages - CMS-632-FOI · CMSForm CMS-632-FOI, Freedom Of Information Act Request
Form CMS-632-FOI is the Centers for Medicare & Medicaid Services (CMS) tracking sheet attached to every Freedom of Information Act request. Fill out the fillable PDF online on FillingPDF and download or print it.
2 pages - CMS-L564 · CMSForm CMS-L564, Medicare Request for Employment Information
Form CMS-L564 is the CMS Medicare Request for Employment Information, which shows group health plan coverage based on current employment when you enroll in Medicare Part B. Fill it out online on FillingPDF and download or print the PDF.
2 pages - CMS-L564 · CMSForm CMS-L564, Request for Employment Information
Form CMS-L564, Request for Employment Information, is the CMS form that shows proof of employer group health plan coverage for Medicare Part B enrollment. Fill it out online on FillingPDF and download or print the completed PDF.
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About the Centers for Medicare & Medicaid Services (CMS)
The listed forms cover several kinds of paperwork rather than one general Medicare application. One group concerns enrollment or coverage status: the Medicare Part B enrollment request is separate from the termination requests, and the two termination titles describe different coverage combinations. Read each title carefully to distinguish hospital insurance and supplementary medical insurance from Part A, Part B, or Part B immunosuppressive drug coverage.
Other forms address employment information, physician or supplier agreements, and health insurance claims. The employment-information request is distinct from the Medicare participating physician or supplier agreement, and both differ from the health insurance claim form. The collection also includes an application for clinical laboratory certification and a Freedom of Information Act request, separate topics from Medicare enrollment and coverage changes.
These are the published forms currently associated with CMS on this page, not a complete inventory of documents the agency may issue. Before using a form, check CMS’s current instructions for the applicable version and any relevant requirements, supporting information, deadlines, fees, or submission method. The form titles identify their topics but do not establish those details.