April 12, 2021

• Additional Provider, Payer and XML Submission Partner FAQs.
• Treating Health Care Provider's Agreement for XML Submission of CMS-1500 Forms and Medical Narrative Reports no longer needs to be notarized.
• The CMS-1500 Guide for New XML Submission Partners has been revised to reflect updated provider agreements (which no longer require notarization).

March 26, 2021

• Updated Additional Payer FAQs

March 10, 2021

• Updated Timeline. Payers will be mandated to accept electronic medical bills from clearinghouses on October 1, 2021. Mandatory submission of CMS-1500 by providers as well as electronic submission of Explanation of Benefits / Explanation of Review has moved to July 1, 2022.

January 13, 2021

• The listing of clearing houses who are testing or approved to become an XML Submission Partner for the CMS-1500 has been updated to include the web address for most submission partners.
• The Claim Adjust Reason Codes (CARCs) and Remittance Advice Remark Codes crosswalk has modified the RARC codes under objection reason #6, added a new objection reason #13 for failure to submit medical bills electronically, and renumbered subsequent objection reasons.

December 14, 2020

• Additional Provider and Payer FAQs

September 10, 2020

• FAQ Clarification
  • FAQ Clarification on payer acceptance of the CMS-1500.

August 13, 2020

• Additional FAQ
  • FAQ clarifies how payers should address the reduction of a bill to align with the Relative Value Unit (RVU) limitations in the Medical Fee Schedule.

July 27, 2020

• Additional FAQ
  • FAQ clarifies the correct approach for billing surgical procedures performed by a surgeon and an assistant
• CMS-1500 Examples

June 4, 2020

• Updated Timeline
• Several XML Submission Partners have been approved for CMS-1500 submissions. View XML Submission Partner Status
• FAQs Clarification
  • Several FAQs have been updated to reflect the changes in the project timeline

April 23, 2020

• CMS-1500: A Guide for New XML Submission Partners

March 26, 2020

• Edits to the XML schema for fields 0, 4, 32 and 33
• CMS-1500 Field Requirements for XML Submission

January 30, 2020

• Examples of paper CMS-1500 submissions were updated to provide dates of service on or after January 1, 2020 (post implementation of the expanded provider legislation).

January 17, 2020

• Medical Narrative Template added to CMS-1500 Requirements page
• FAQs Clarification
  • Several FAQs have been updated to reflect the new Expanded Provider Law, Medical Narrative Template and change in calendar year