Claim Form Rule: Adding or Removing CLIA Number

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What claim change is needed?

Add the facility's Clinical Laboratory Improvement Amendments (CLIA) number to the CMS-1500. To add the CLIA number to the facility, use the guide in Manage Facilities.

Box Number

UB-04: n/a

CMS-1500: Box 23


  1. Navigate to Management Center > Claim Rules
  2. Click "Create Claim Form Rule".
  3. Select the practice.
  4. Name the claim rule. mceclip3.png
  5. Set Claim Type to "Professional".
  6. Set Conditions for claim rule to meet.
  7. Under Available Behaviors, select "Facility - CLIA Number". mceclip0.png
  8. Click Add. 
  9. Select "CLIA Number - Require and Write"mceclip1.png
  10. Click Create.

Related Articles

To read more about how to set claim rule conditions and order, see the Claim Rule: Setting Claim Rule Conditions article.

To read more about how to set up a claim rule to be effective as of a certain date, see the Scheduled Change Sets article.

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