Avoid Claim Rejections with Legible Signatures

An easy way to avoid Medicare claim rejections is to make sure signatures on notes and orders meet Medicare standards. 

Medicare requires a legible handwritten or electronic signature on orders and other medical record documentation. Stamped signatures are not accepted. 

However, initials and illegible signatures are allowed in some circumstances. These include: 

  • The illegible signature or initials are over a typed or printed name.
  • The identity of the signer is indicated in the letterhead, address, or other information on the page.
  • Documentation is accompanied by a signature log or attestation statement.
  • The handwritten note is unsigned but is written in the same handwriting as another entry on the page that is signed. 

The Centers for Medicare and Medicaid Services (CMS) has created a chart to help you determine when a signature meets Medicare requirements. The chart begins on page 12 of change request 6698.  

An MLN Matters article also addresses the legible signature requirements.

Add Your Comments


The Pennsylvania Medical Society encourages lively debate, but please behave courteously and responsibly. Comments that include profanity, personal attacks (including language that could potentially identify an individual), or any other inappropriate, offensive, or illegal material will be removed. For more information, please see our Terms of Use. We do not answer legal questions on line. Members seeking general information about laws and regulations affecting medical practice may call our member resource line, (800) 228-7823.

Display name as (optional):

Comments (max 2000 characters):




Comments: 2


We assume the 3-digit ID number is assigned by your hospital. If that is the case, then that will not be acceptable to Medicare unless it is accompanied by a signature log that details to whom the 3-digit ID number belongs. This would be the only way Medicare could trace the ID number to you.

PA Medical Society at 5/17/2010 2:50:58 PM


Our hospital requires a 3 digit ID # next to our illegible signatures will that suffice?

anonymous at 5/9/2010 7:48:15 AM

Last Updated: 4/27/2010
From: 
Email:  
To: 
Email:  
Subject: 
Message: