Free Fillable Superbill and CMS 1500 Forms for Practitioners
Short answer: If you do not use billing software and your client just needs a form, go to mariematteson.com/resources and download the blank fillable superbill and the fillable CMS 1500, the form still widely called the HCFA. Both are free and both are completely fillable, so you can complete them on screen. Save the file or make a photocopy so you always keep a clean blank original. Fill out the superbill, hand it to your patient, and tell them to attach the prescription from their physician, the one carrying the diagnosis code, before they submit it to their insurance company.
Who this is for
Not every practitioner wants billing software. A massage therapist who wants to hand a client something they can submit themselves. A counselor running a cash practice whose clients want to try for reimbursement. If that is you, you do not need a system. You need a fillable PDF.
These two forms were built from scratch to fill that gap, and they are free with no email required. They are blank templates for your own use. They are not Office Ally forms and they are not tied to any software.
The steps
Go to mariematteson.com/resources.
Download the blank fillable superbill PDF.
Download the fillable CMS 1500.
Save the file, or make a photocopy, so you always keep a clean blank original to work from.
Fill out the superbill on screen. Both forms are completely fillable.
Go to the payment area toward the bottom of the form. If you have already been paid, enter the amount you were paid.
Include instruction indicating who the reimbursement should go to, whether that is the patient or the practitioner.
Hand the completed form to the patient or client.
Tell the patient to attach the prescription from their physician. That prescription carries the diagnosis code.
The patient submits the superbill together with the prescription to their insurance company to seek reimbursement.
If the payer wants a claim form instead, fill out the CMS 1500 the same way and give that to the patient to submit.
Why the payment section is not a detail
Whether you have already been paid is not something to sort out later, because it decides where the reimbursement goes. Fill the paid amount in at the time you complete the form, along with the instruction about who should be paid. Leave it blank and the money can be directed to the wrong party, which either leaves you chasing a payment the client already received, or leaves the client confused about a payment they were not expecting.
The mistake this prevents
The big one is handing over a superbill without the prescription. A completed superbill describes the service you provided. What it does not do on its own is establish a covered condition, and that is what the physician's prescription supplies, because it carries the diagnosis code. The client submits a form that is filled out correctly, waits, and gets nothing back, with no clear explanation of why. Then they come back to you, and you did everything right on the form itself.
Your job here is not just to complete the paperwork. It is to tell the client what else has to go in the envelope. Say it out loud when you hand the form over, because the client has no way of knowing.
More Office Ally training
Watch the walkthrough: Office Ally User Tips playlist
Free forms and resources: mariematteson.com/resources
Office Ally consulting and training: mariematteson.com/officeally
Medical Receptionist and Biller Course: mariematteson.com/medcourse
Marie Matteson, MS, is a healthcare consultant, educator, and Office Ally specialist with more than 30 years in healthcare, emergency medicine, and practice management. Helping you understand what's really going on.
All patient information referenced here has been redacted. These forms are provided as blank templates for practitioner convenience. Reimbursement depends entirely on the patient's own plan, and submitting a superbill or a claim form is never a guarantee of payment. Form versions and payer requirements change over time. This content is educational and is not billing, legal, or coding advice. Always follow your payer contracts, your practice policies, and current coding guidelines. Not affiliated with or endorsed by Office Ally.
© Marie Matteson. All rights reserved.
