VERIFIED OFFICIAL SOURCE

CMS — CMS-1490S Patient's Request for Medical Payment

cms.gov

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Used by1 published procedure

Last checked2026-10-09

Source domaincms.gov

Official source URLhttps://www.cms.gov/cms-1490s-patients-request-medical-payment

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USUnited States

How to File a Medicare Claim Yourself When Your Provider Does Not Submit It

Learn when you can file your own Original Medicare claim using Form CMS-1490S, what documents to include, where to mail it and how to request reimbursement.

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Rules, fees, forms and processing routes can change. Helpydo connects procedural guidance to the responsible authority so you can verify time-sensitive details before acting.