New Fact Sheet Available for Health Care Providers

As you are aware, mandatory use of the CMS-1500 form and accompanying medical narrative went into effect on July 1, 2022. As mentioned in a GovDelivery dated July 8, 2022, health care providers must use either the medical report template or alternately, must include the following in the medical narrative attachment, either at the top of, or prominently displayed on, the medical narrative that accompanies the CMS-1500 form:

• injured worker’s temporary impairment percentage,
• work status, and
• the causal relationship of the injury

To serve as an additional reference for health care providers, the Workers’ Compensation Board (Board) has created a fact sheet called Treating Workers’ Comp Patients: Three Musts for Medical Reports, which outlines this requirement in further detail and provides additional information and resources.

Note: Certain health care providers, including occupational therapists, physical therapists, and acupuncturists, should report on work status only. Physician assistants should always report on work status and ongoing degree of disability, and may do so independently, and when they report on causal relationship and initial degree of disability, must do so under the supervision of a physician. Visit the Medical Narrative Requirements section of the Board’s website to view the complete chart.

Additional Resources

Visit the Board’s website for CMS-1500 news, FAQs, and more. The Board has also created a special webpage dedicated to sharing timely updates on various Board initiatives with a health care provider focus. Visit What Providers Need to Know to view the latest! 

For CMS-1500 feedback and questions, email CMS1500@wcb.ny.gov. For clinical feedback and questions, email provider@wcb.ny.gov.