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Knowledgebase: How to Fill Out The CMS-1500 Form > The CMS-1500 Form - Fields 1–13: Patient and Insured Information
Field 9 a - Other Insured's Policy or Group Number
Posted by Dan Perrine, Last modified by Dan Perrine on 28 March 2018 06:53 AM

The “Other Insured’s Policy or Group Number” identifies the policy or group number for coverage of the insured as indicated in Item Number 9.

Enter the policy or group number of the other insured.

Do not use a hyphen or space as a separator within the policy or group number.

MEDICARE - Enter the policy and/or group number of the Medigap insured preceded by MEDIGAP, MG, or MGAP.

NOTE: Item 9d must be completed, even when the provider enters a policy and/or group number in item 9a.
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