Indiana § 16-51-1-5 "Individual provider form"

Indiana Statutes

§ 16-51-1-5 — "Individual provider form"

Indiana § 16-51-1-5

Title 16HEALTH

Art. 51HEALTH CARE REQUIREMENTS

Ch. 1Health Care Billing

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Bluebook

Ind. Code § 16-51-1-5 (2026).

Text

(a)As used in this chapter, "individual provider form" means a medical claim form that:

(1)is accepted by the federal Centers for Medicare and Medicaid Services for use by individual providers or groups of providers; and

(2)includes a claim field for disclosure of the site at which the health care services to which the form relates were provided.

(b)The term includes the following:

(1)The CMS-1500 form or its successor form.

(2)The HCFA-1500 form or its successor form.

(3)The HIPAA X12 837P electronic claims transaction for professional services, or its successor transaction.

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(a) As used in this chapter, "individual provider
form" means a medical claim form that:
(1) is accepted by the federal Centers for Medicare and Medicaid
Services for use by individual providers or groups of providers;
and
(2) includes a claim field for disclosure of the site at which the
health care services to which the form relates were provided.
(b) The term includes the following:
(1) The CMS-1500 form or its successor form.
(2) The HCFA-1500 form or its successor form.
(3) The HIPAA X12 837P electronic claims transaction for
professional services, or its successor transaction.