I don't believe that CMS has any samples of billing tickets because this is normally something that is specialty specific. I recommend that you contact your specialty society as they normally have tools and templates for their members to utilize with the common codes used per that specialty.
As an example the American Academy of Family Physicians has one on their website that can be accessed. Follow this link http://www.aafp.org/online/en/home/p...pmtoolbox.html and it is labeled FPM Superbill.
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