This is a listing of commonly-used Medicare forms. If the form you need isn't available through Palmetto GBA, please refer to the forms listing on CMS.gov.
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💡 Don't know the form you need? Use our Form Finder.
Please select an answer for each of the questions that will be shown below. You will be directed to the correct form based upon your answer to each of the questions. These forms should only be submitted to regarding beneficiaries or claims using the instructions at the bottom of the form. To change your answer to a previous question, click on the question text. Questions and their answers might differ when changing previous question.
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Palmetto GBA Form Finder
Please select your line of business from the list below:
Jurisdiction J Part A
Part A Providers in Alabama, Georgia and Tennessee
Jurisdiction J Part B
Part B Providers in Alabama, Georgia and Tennessee
Jurisdiction M Part A
Part A Providers in North and South Carolina, Virginia and West Virginia
Jurisdiction M Part B
Part B Providers in North and South Carolina, Virginia and West Virginia
Jurisdiction M Home Health & Hospice
Home Health and Hospice providers in Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee and Texas
Railroad Medicare Providers
Part B Medicare Services for Railroad Beneficiaries Nationwide