CMS-1500 Field Guide
CMS-1500 Box 11c: Insurance plan/program name
Reports the insurance plan or program name associated with the insured.
Reviewed September 2026 · Educational reference — verify payer and program requirements.
What Box 11c is for
Reports the insurance plan or program name associated with the insured.
What to verify before filing
Compare the entry to the current patient, provider, payer, authorization or service documentation that supports the claim. Avoid copying information from an old claim without confirming that it still applies.
How this field connects to the rest of the claim
CMS-1500 fields work together. A value can be valid by itself but still conflict with the patient, provider, diagnosis, service-line, place-of-service or billing information elsewhere on the claim.
Common workflow mistakes
- Using a value from a prior claim without checking the current payer or patient record.
- Assuming a field is always required or always optional for every payer.
- Entering data in a reserved or differently designated field because it appears to have open space.
- Failing to reconcile this field with related service-line, provider or claim-level information.
Official instructions
Use the current NUCC 1500 Reference Instruction Manual and the payer's own billing guidance. For Medicare paper claims, also see CMS professional paper claim guidance.
Frequently asked questions
What goes in CMS-1500 Box 11c?
Reports the insurance plan or program name associated with the insured.
Is Box 11c always required?
Not necessarily. Requirements can vary by payer, program, provider type and claim circumstances. Verify the current official instructions and payer rules.