CMS-1500 Electronic Forms Submission

Overview

To reduce administrative burden and increase health care provider participation in the workers' compensation system so injured workers' have better access to medical care, the Workers' Compensation Board (Board) made a strategic decision to transition to the CMS-1500 universal billing form. The Board replaced 12 custom forms with the CMS-1500 and its use became mandatory in July 2022.

The CMS-1500 must be submitted with a detailed narrative report to be considered a valid submission. The Board has developed a template providers can use to create the medical narrative report that accompanies provider submissions of the CMS-1500. This template, along with sample CMS-1500 forms by provider type and other resources, is available on the Requirements page.

As of August 1, 2025, the Board requires all health care providers in the workers' compensation system — regardless of office size or patient population — to submit the CMS-1500 universal medical billing form electronically through a Board-approved submission partner (also known as XML submission partner). This applies to each individual provider in a practice who treats workers' compensation patients. See Subject Number 046-1707. If a provider currently works with a billing clearinghouse, they can contact the company to see if they work (or can work) with a Board-approved electronic submission partner.

Important: The workers' compensation payer can deny payment of services if the CMS-1500 was not submitted through a Board-approved electronic submission partner and the Board will not enforce payment.

Electronic Submission Partners

In order to ensure the integrity of the CMS-1500 electronic submission process, the Board requires all prospective submission partners to engage in a rigorous testing effort. Additional information regarding the testing process can be found in CMS-1500 Guide for Electronic Submission Partners.

Listed below are companies who have been approved as an electronic submission partner. Electronic submission partners offer different service features, including accepting paper and converting to an electronic format, so providers should reach out to multiple submission partners to determine which one is best for them.

Approved electronic submission partners have executed a legal agreement with the Workers' Compensation Board.

If you are interested in participating as an electronic submission partner in the Board's CMS-1500 Electronic Forms Submission Program, please contact the WCB Online Services Technical Support Unit.

Electronic submission partners	Address	Approved: CMS-1500	Accepts paper and converts to electronic	Pricing information
Carisk Intelligent Clearinghouse Phone: (973) 795-1641 Email: cicsales@cariskpartners.com Website: www.cariskic.com	25A Hanover Road, Suite 201 Florham Park, NJ 07932	Approved: CMS-1500 – 05/21/2020	X Accepts paper and converts to electronic	Pricing information: 50 cents per electronic bill accepted by payer 50 cents per electronic bill accepted by WCB Additional $1 processing fee for conversion from paper
DaisyBill Phone: (646) 847-7711 Email: info@daisybill.com Website: www.daisybill.com	34 West 15th Street, 3rd Floor New York, NY 10011	Approved: CMS-1500 – 06/17/2021	X Accepts paper and converts to electronic	Pricing information: $300 per month (for up to 150 transactions, also includes additional services)
Data Dimensions (WorkCompEDI®) Phone: (608) 563-3019 Email: info@datadimensions.com Website: datadimensions.com/getstarted/	400 Midland Ct Janesville, WI 53546	Approved: CMS-1500 – 10/07/2021	X Accepts paper and converts to electronic	Pricing information: 65 cents per bill (electronic submission to payer and WCB); 85 cents per bill (conversion from paper to electronic for paper bills that are faxed to Data Dimensions)
EZ1500 – IT SOLUTIONS OF WNY Phone: (716) 444-4474 Email: support@itswny.com Website: www.ez1500.com	5758 Big Tree Rd STE 200 Orchard Park, NY 14127	Approved: CMS-1500 – 02/11/2020	X Accepts paper and converts to electronic	Pricing information: 45 cents per electronic bill accepted by payer 45 cents per electronic bill accepted by WCB Additional $1 processing fee for conversion from paper
Jopari Solutions, Inc. Phone: (800) 630-3060 Email: support@jopari.com Website: www.jopari.com	1855 Gateway Boulevard, Suite 500 Concord, CA 94520	Approved: CMS-1500 – 06/17/2021	X Accepts paper and converts to electronic	Pricing information: Average of 50 cents per electronic bill to payer Average of 50 cents per electronic bill to WCB Additional fee ranging from $1–$3 for conversion from paper

More electronic submission partners to be added

Coming on in Q4: Bishop Healthcare Technologies. Please watch for more information!

IMPORTANT: The Workers' Compensation Board does not endorse any of the electronic submission partners who have been approved to provide these services. The Board has no knowledge of any other aspect of the electronic submission partner's business. Thus, the Board makes no representations or warranties, express or implied, as to any aspect of the electronic submission partner's business.

Registration for CMS-1500 Electronic Forms Submission

Providers

With the CMS-1500 submission mandate, as of August 1, 2025, the NYS Workers' Compensation Board requires all health care providers, regardless of office size or patient population, to submit the CMS-1500 universal medical billing form electronically through a Board-approved electronic submission partner.

To make the process as easy as possible, as of July 28, 2025, the Board removed the requirement for providers to log into the Medical Portal and accept the "Agreement for electronic submission of CMS-1500" before working with a submission partner.

After August 1, 2025, the Board will not act on, or enforce payment of, paper CMS-1500 forms and workers' compensation payers can deny them, which means the submitting provider will not be paid. To ensure uninterrupted payment for services, the Board urges all providers to transition to electronic submission now.

Electronic submission partner

Businesses who would like to register to become an electronic submission partner must first register with the Board and will be required to successfully pass XML testing prior to their approval to submit XML data to the Board. Once the registration is received and eligibility to participate verified, the electronic submission partner will be required to sign and return the testing legal agreement. The Board will notify the electronic submission partner by email, at the email address provided on the registration, that the registration has been approved and testing can begin. Once the electronic submission partner has successfully passed testing, the Board will notify the electronic submission partner by email that they have been approved for production submissions and require the electronic submission partner to sign and return a production legal agreement.

Additional information regarding becoming an electronic submission partner and the testing process.

Resource

CMS-1500 Guide for Electronic Submission Partners

CMS-1500 Electronic Forms Submission XML Submission of Board Forms

MenuSections