CMS-1500 News
January 13, 2021
- The listing of clearinghouses 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 FAQs
- Providers: Questions 12 through 15
- Payers: Questions 10 and 11
September 30, 2020
- New videos available:
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
March 26, 2020
- Edits to the XML schema for fields 0, 4, 32 and 33
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
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.
-
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.
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."
February 28, 2019
February 26, 2019
- Updated:
-
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
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.
