CMS-1500 electronic mandate approaching!
Cost offset available now.
The Board encourages health care providers who are still submitting paper CMS-1500 medical bills to move to electronic submission as soon as possible to take advantage of increased accuracy and more timely payment, among other key benefits.
As we get closer to the August 1, 2025, mandate for providers to submit the CMS-1500 form electronically through a Board-approved electronic submission partner, there are a few important reminders to share:
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Cost offset: The CPT code 99080 enables health care providers to get reimbursed up to $1.00 for every electronic CMS-1500 bill submission. This code is already available to any provider submitting bills electronically.
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Payer penalties: Payers who do not properly reimburse health care providers for CPT code 99080 may be subject to penalties from the Board.
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Electronic submission partners: There are currently eight Board-approved electronic submission partners to choose from. Some will continue to accept paper forms from health care providers and then convert them to electronic bills for submission. See the full list of partners and their contact information at wcb.ny.gov/submissionpartners.
Make the move today!
Don’t wait until August to make a change that will benefit you immediately! If you have questions or would like assistance with electronic submission, email CMS1500@wcb.ny.gov.
For more information, please check out the following resources:
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