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September 15, 2006

CMS 1500-Revision Information

The latest revision to the 1500 Health Insurance Claim Form (version 08/05), which accommodates the reporting of the National Provider Identifier (NPI), has been approved by the Office of Management and Budget (OMB). The transitioning timeline for implementation is as follows:

  • October 1, 2006: Health plans, clearinghouses and other information support vendors should be ready to handle and accept the revised (08/05) 1500 Claim Form;
  • October 1, 2006 - February 1, 2007: Providers can use either the current (12/90) version or the revised version of the 1500 Claim Form;
  • February 1, 2007: The current version of the 1500 Claim Form is discontinued; only the revised form is to be used. Although earlier submissions may have been on the current form, all rebilling of claims should use the revised form from this date forward.
The proposed Medicare implementation timeline for the new Form CMS-1500 (08/05) calls for optional use starting January 2, 2007, through March 30, 2007, but will be mandatory starting April 2, 2007. Providers will need to check with their payor and/or clearinghouses to determine when they will begin to accept the revised forms. For a list of CMS 1500 (12/90) and CMS 1500 (08/05)
forms, click here.





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