June 2007

Medicare to reject ‘old’ CMS-1500 forms after June 29

“Old” CMS-1500 (12/90) forms received after June 29 will be rejected by Medicare, according to the Centers for Medicare and Medicaid Services (CMS).

Effective July 1, 2007, Medicare will reject any 12-90 version forms received and will return them to the submitters for resubmission on the 08-05 version of the form.

The “old” CMS-1500 forms, which were originally scheduled to be terminated by April 1, were granted an extension earlier this year to investigate reported printing problems with the new CMS-1500 (08/05 version) forms. It was determined the printing issue did not prevent the forms from being read by the Optical Character Recognition software used for most paper claims sent to Medicare.

However, there were a few exceptions, which involved a couple of Medicare contractors. In those cases, the misprinted forms were taken off the market and purchasers furnished correctly printed forms. As result, it was determined there is no need for Medicare to continue to accept the “old” CMS-1500 (12/90 version) forms.

The CMS-1500 claim form was updated to accommodate the National Provider Identifier (NPI), a unique provider number mandated by the Health Insurance Portability and Accountability Act (HIPAA). The new forms have fields for reporting both provider NPIs and Legacy IDs.

Source: Centers for Medicare and Medicaid Services, www.cms.hhs.gov

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