Block 33 on the CMS-1500 form captures which of the following?

Block 33 on the CMS-1500 form captures which of the following?

• A. The patient's name
• B. The service date
• C. The facility's NPI
• D. The billing provider's name, address, ZIP, and telephone number

Answer: (D)

Block 33 contains the billing provider information—the entity that submits the claim. This is where you put the billing provider’s name, street address, ZIP code, and telephone number, with the NPI usually included in the same area. This data helps the payer identify who is billing for the services and how to contact them if questions arise. The patient’s name is found in a different section that records patient demographics, and the service date is captured in the dates-of-service area. The facility’s NPI appears in its own area of the form, separate from the billing provider details.

Block 33 contains the billing provider information—the entity that submits the claim. This is where you put the billing provider’s name, street address, ZIP code, and telephone number, with the NPI usually included in the same area. This data helps the payer identify who is billing for the services and how to contact them if questions arise.

The patient’s name is found in a different section that records patient demographics, and the service date is captured in the dates-of-service area. The facility’s NPI appears in its own area of the form, separate from the billing provider details.