Providers subject to electronic CMS-1500 mandate

New York State Workers' Compensation Board sent this bulletin at 08/13/2025 01:00 PM EDT

Providers subject to electronic CMS-1500 mandate

As of August 1, 2025, all treating healthcare providers in the workers' compensation system are required to submit the CMS-1500 universal billing form electronically, through a Board-approved electronic submission partner, in order to be paid for services.

The electronic submission mandate does not apply to pharmacies or durable medical equipment (DME) suppliers.

Payers should not deny bills from pharmacies and DME suppliers who did not submit their bills electronically, and CARC Code 16/RARC Code N34 should not apply to pharmacies and DME suppliers.

MORE INFORMATION

Visit wcb.ny.gov/CMS-1500 for complete details, including FAQs.

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Questions? Email CMS1500@wcb.ny.gov.

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Learn more at wcb.ny.gov/supportservices

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