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The following forms are designed for Part B providers who submit claims to CGS. All forms are in the Portable Document Format (pdf). If you do not have Adobe Reader software, you can download it at no cost.

Instructions: Type directly into the required fields electronically, then print (and sign, if required). Illegible forms may cause a delay in processing.

Forms are organized by the following topics:


Beneficiary 2nd level screening/BIU


Submit Reopening Requests instantly through myCGS! Click here to learn more.

CMSExternal Website



Overpayment & Refunds

Medical Review

Roster Billing

Updated: 10.15.20

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