Medicare appeal guide
CMS-20027 vs CMS-20033: which Medicare appeal form do you need?
CMS-20027 and CMS-20033 are both Medicare appeal forms, but they belong to different levels of the process. The simplest way to think about it is this: CMS-20027 is usually the first appeal form, and CMS-20033 is used only after that first appeal has already been decided. PostalForm offers online workflows for both forms so you can generate the right PDF and mail the packet without hand-editing the official form.
Published Apr 11, 2026
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Key takeaways
- CMS-20027 is the redetermination request form for the first level of Original Medicare fee-for-service appeals.
- CMS-20033 is the reconsideration request form for the second level, after an unfavorable redetermination.
- CMS-20027 is generally mailed to the Medicare Administrative Contractor listed on the notice.
- CMS-20033 is generally mailed to the Qualified Independent Contractor listed in the reconsideration instructions.
- If you have not yet received a redetermination decision, CMS-20033 is usually too early.
The short answer
Use CMS-20027 when you are challenging the initial Medicare claim decision. Use CMS-20033 only after you already received a redetermination result and want the next level of review.
That sequence matters because each form routes to a different reviewer and supports a different stage of the appeal record.
When CMS-20027 is the right form
CMS-20027 is usually the right choice when:
- You received a Medicare Summary Notice or initial determination you disagree with
- This is your first written appeal for the claim
- You want the Medicare contractor to review the denial again
This is the first level of the Original Medicare appeals ladder.
When CMS-20033 is the right form
CMS-20033 is usually the right choice when:
- You already filed a redetermination request
- You received an unfavorable or partially favorable redetermination result
- You want the second-level review by a Qualified Independent Contractor
This form belongs to the next stage, not the starting point.
Side-by-side comparison
| Topic | CMS-20027 | CMS-20033 |
|---|---|---|
| Appeal level | First level | Second level |
| Appeal type | Redetermination | Reconsideration |
| What it challenges | Initial Medicare claim decision | Redetermination result |
| Where it usually goes | Medicare Administrative Contractor | Qualified Independent Contractor |
| What should travel with it | Notice details and supporting evidence | Redetermination notice plus supporting evidence |
The easier workflow: pick the stage first, then build the packet
If you are unsure which form to use, decide where you are in the appeal chain before you start typing into any PDF:
- Look at the most recent Medicare notice you received.
- If it is the initial denial, start with CMS-20027.
- If it is already a redetermination result, use CMS-20033.
- Build the packet around that stage's notice and evidence.
PostalForm helps because each workflow is already scoped to the form's role in the appeal process.
What to include with each packet
For CMS-20027, gather:
- The Medicare Summary Notice or initial determination details
- The item or service being appealed
- A short explanation of why you disagree
- Supporting bills, records, or correspondence
For CMS-20033, gather:
- The redetermination notice
- A clearer second-level explanation of why the prior decision was wrong
- Supporting evidence organized in packet order
Where people get tripped up
The most common mistake is starting with CMS-20033 because it sounds more formal or more complete. It is not the form for skipping the first step. Another common mistake is reusing an old address from a prior appeal stage. The routing instructions can change between the contractor review and the Qualified Independent Contractor review.
How CMS-20031 fits in
CMS-20031 is a different form entirely. It is used to transfer appeal rights for one listed item or service to the provider or supplier that furnished it. It is not a substitute for either CMS-20027 or CMS-20033.
Sources
FAQs
- Which form comes first, CMS-20027 or CMS-20033?
- CMS-20027 comes first. CMS-20033 is for the next level after redetermination.
- Can I skip straight to CMS-20033?
- Usually no. CMS-20033 is tied to a prior redetermination result.
- Does each form go to the same mailing address?
- No. CMS-20027 generally goes to the contractor listed on the notice, while CMS-20033 goes to the Qualified Independent Contractor listed in the reconsideration instructions.
- Can I complete both forms online?
- Yes. PostalForm offers guided workflows for both forms so you can generate the correct PDF before mailing.
Ready to send it?
Start with the form that matches your current appeal stage, generate the PDF online, and mail the packet to the address listed in the current Medicare notice.