---

September 30, 2020

• New videos available:
  • Billing Updates for Providers: CMS-1500 and Expanded Provider Initiatives (24 min)
  • Billing Updates for Payers: CMS-1500 and Expanded Provider Initiatives (25 min)

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

November 22, 2019

• Edits to the XML schema for field 9A
  • CMS-1500 Field Requirements for XML Submission

September 26, 2019

• Additional FAQs:
  • Webinar Q&As - September 2019: Questions 1 through 18

September 6, 2019

• Additional FAQs:
  • XML Submission Partners: Question 15
• FAQs Clarification:
  • XML Submission Partners: Question 10

August 6, 2019

The Workers’ Compensation Board has developed a training video to show health care providers, and all others who will be using Form CMS-1500, how to use the form and the required narrative reports to bill for their services to workers’ compensation patients.

You can view the video here: CMS-1500 Training Video

The Board will also hold two follow-up Q&A webinars so you can get answers to any questions you may have after viewing the training video and reading the CMS-1500 FAQ.

You’re encouraged to view the training video before attending one of the webinars.

The webinars will be held on:

September 17, 2019
8:30 a.m. - 9:30 a.m.
Register for Webinar

September 18, 2019
4:00 p.m. - 5:00 p.m.
Register for Webinar

August 2, 2019

• Updated FAQs:
  • XML Submission Partners: Question 14
  • Providers: Question 17

August 1, 2019

• Minor edits to the XML schema were made to the number of allowable characters for the WCB Authorization Number in field 19.
  • CMS-1500 XML schema
  • CMS-1500 Field Requirements for XML Submission
• Updated FAQs:
  • Providers: Question 16

May 31, 2019

• Updated FAQs:
  • XML Submission Partners: Question 10
  • Payers: Questions 1 & 5
• Minor edits to the XML schema were made to remove the document control ID number and add an attachment control number in field 19. Information was added to the CMS-1500 Field Requirements for XML Submission spreadsheet regarding validations that may lead to file or document rejection by the Board.
  • CMS-1500 XML schema
  • CMS-1500 Field Requirements for XML Submission

April 25, 2019

• Posted video: Cooperative Exchange Webinar: NY CMS-1500 XML Initiative

March 29, 2019

• CMS-1500 Onboarding Instructions for new XML submission partners.
• FAQs
  • XML Submission Partners: Question 9 updated.

March 6, 2019

• Minor edits to the XML schema were made to acknowledge that the CMS-1500 is sent to the payer (vs. carrier) and to change the Carrier W# requirement to "situational."
  • CMS-1500 XML schema
  • CMS-1500 Field Requirements for XML Submission

February 28, 2019

• Listing of clearinghouses who are interested, testing or approved to become an XML Submission Partner for the CMS-1500.

February 26, 2019

• Updated:
  • Paper CMS-1500 Requirements
  • CMS-1500 Examples
• Additional FAQs
  • Payer: Question 7 & 8
  • Provider: Questions 9 through 15
• FAQs Clarification
  • General: Questions 14 & 15
  • XML Submission Partners: Questions 9, 11 & 12
  • Payers: Questions 4 & 5

November 15, 2018

• Updated CMS-1500 XML schema
• CMS-1500 Field Requirements for XML Submission
• Additional FAQs
  • XML Submission Partners: Question 13
  • Implementation dates have been updated throughout
• Updated CMS-1500 Requirements

October 11, 2018

• Additional FAQs
  • XML Submission Partners: Questions 10 through 12

September 27, 2018

• Additional FAQs
  • General: Questions 21 through 23
  • Providers: Question 8
  • XML Submission Partners: Questions 7 through 9

August 31, 2018

• Updated CMS-1500 XML schema
• CMS-1500 Field Requirements for XML Submission

August 7, 2018

• Additional FAQs
  • General: Questions 17 through 20
  • Providers: Questions 6 and 7
  • Payers: Questions 4 through 6
• FAQ Clarification
  • Payers: Question 3

July 25, 2018

• Additional FAQs
  • General: Questions 4 through 16
  • Providers: Questions 4 and 5
  • XML Submission Partners: Questions 5 and 6
  • Payers: Question 3

July 20, 2018

• Draft CMS-1500 XML schema is now available.

July 16, 2018

• Subject Number 046-1079: Board Announces Technical Specifications for CMS-1500 Initiative