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MIR-2007 07B, July 2007
MLN Matters. . .Information for Medicare Providers
(Issued by the Centers for Medicare & Medicaid Services)
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New Deadline for Required Submission of the Form CMS-1500 (08-05) (MM5616)
Provider Types Affected
Physicians and suppliers who qualify for an exemption from the mandatory electronic claims submission requirements, and who submit Medicare claims to carriers, Medicare Administrative Contractors (MACs), and durable Medical Equipment Medicare Administrative Contractors (DME MACs) using the paper claim Form CMS-1500.
Provider Action Needed
CR 5616, from which this article is taken announces that, beginning July 2, 2007, you must use the Form CMS-1500, version (08-05) for paper claims submission to Medicare. Claims received on or after July 2, 2007 using Form CMS-1500, version (12-90) will be rejected.
Make sure that your billing staffs use Form CMS-1500 (08-05) for your claims, beginning July 2, 2007.
Background
The Form CMS-1500 is the paper claim form that physicians and suppliers, who qualify for an exemption from the mandatory electronic claims submission requirements (as set forth in the Administrative Simplification Compliance Act,
Public Law 107-105 (ASCA) and the implementing regulation at 42 CFR 424.32), use to submit claims.
CR 5568, released March 19, 2007, instructed Medicare contractors to continue to accept the earlier (12-90) version of Form CMS-1500 (tentatively until June 1, 2007), because of reports that some vendors had printed the newer (08-05) version of the form incorrectly. After analysis, however, the problem does not appear to be as widespread as previously suspected.
Therefore, CR 5616, from which this article is taken, announces, based on the information at hand, that beginning July 2, 2007, you will need to submit claims using the Form CMS-1500 (08-05).
Note: CR5616 addresses submission of the revised Form CMS-1500 paper claim form only, and has no bearing on the implementation of the National Provider Identifier (NPI), nor does CR5616 mandate the submission of the NPI by July 1, 2007.
Additional Information
You can find more information about the official instruction issued to your Medicare contractor on this issue (CR5616) at www.cms.hhs.gov/Transmittals/downloads/R1247CP.pdf  on the CMS Web site.
If you have any questions, please contact your carrier, MAC, or DME MAC at their toll-free number, which may be found at www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip. 
Disclaimer
This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents.
MLN Matters Number: MM5616
Related Change Request (CR) #: 5616
Related CR Release Date: May 25, 2007
Effective Date: July 1, 2007
Related CR Transmittal #: R1247CP
Implementation Date: July 2, 2007
PQRI Information Available
A new CMS Web page dedicated to providing information on the Physician Quality Reporting Initiative (PQRI) is now available.
On December 20, 2006, the President signed the Tax Relief and Health Care Act of 2006 (TRHCA). Section 101 under Title I authorizes the establishment of a physician quality reporting system for eligible professionals by CMS. CMS has titled the statutory program the Physician Quality Reporting Initiative. For more information, visit http://www.cms.hhs.gov/pqri  on the CMS Web site.
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