Final answer:
The CMS-1500 form is used to report CPT and HCPCS Level II codes and modifiers, typically used by non-institutional medical providers and suppliers for billing purposes.
Step-by-step explanation:
The form used to report CPT (Current Procedural Terminology) and HCPCS Level II (Healthcare Common Procedure Coding System) procedure and service codes, along with the appropriate modifiers, is the CMS-1500 form. The CMS-1500 form is the standard insurance claim form used by non-institutional providers and suppliers to bill Medicare and Medicaid, as well as private insurers. It captures information about the patient, the services provided, the charges, and the medical provider.