Medical Staff Pulse is
a Publication of the Chief of Staff
New Medicare Claim Forms

Beginning in July, Medicare will no longer accept "old" CMS-1500 (12-90) claim forms.

Effective July 1, 2007, the Centers for Medicare & Medicaid Services will reject any 12-90 version forms received. Forms not received by Friday, June 29 will be returned for resubmission on the new 08-05 version of the form, which replaces the 12-90 version.

The CMS-1500 form is the standard paper claim form used by a non-institutional provider or supplier to bill Medicare carriers and Medicare administrative contractors when a provider qualifies for a waiver from the Administrative Simplification Compliance Act requirement for electronic submission of claims. The form is also used to bill Medicaid State Agencies.

The CMS-1500 claim form was updated to accommodate the National Provider Identifier (NPI). Although HIPAA requires that NPIs be used on electronic standard format claims, it does not require that NPIs be reported on paper claim forms. Healthcare plans have the option to require NPIs on paper claims.

For more information, please visit the CMS website at http://www.cms.hhs.gov/ and click on the related article listed under "CMS Highlights."