{"data":{"id":"us-in/ic-16-51-1-5","jurisdiction":"us-in","citation":"IC 16-51-1-5","heading":"\"Individual provider form\"","body":"Sec. 5. (a) As used in this chapter, \"individual provider form\" means a medical claim form that:\n(1) is accepted by the federal Centers for Medicare and Medicaid Services for use by individual providers or groups of providers; and\n(2) includes a claim field for disclosure of the site at which the health care services to which the form relates were provided.\n(b) The term includes the following:\n(1) The CMS-1500 form or its successor form.\n(2) The HCFA-1500 form or its successor form.\n(3) The HIPAA X12 837P electronic claims transaction for professional services, or its successor transaction.","path":["TITLE 16. HEALTH","ARTICLE 51. HEALTH CARE REQUIREMENTS","Chapter 1. Health Care Billing"],"source_url":"https://iga.in.gov/ic/2026/Title_16.html#16-51-1-5","current_through":"2026","vintage":"2026","retrieved_at":"2026-09-11T20:02:18Z","sha256":"4b1806f9dedb109dc30b2467cc1126593b3a12d5e4a564f15f8ec82cd9c0afa7","source_id":"us-in","stale":false,"prev":"us-in/ic-16-51-1-4","next":"us-in/ic-16-51-1-6"},"notice":"GroundRules: Original legal text. Not legal advice."}