Part B CMS-1500 Form (8-2005) Update
Temporary Grace Period

The CMS 1500 (Version 12-1990) form was revised in August 2005 with a target implementation date of April 1, 2007 for all providers/suppliers and most payers per HIPAA Standard Transaction and Code Sets. This form had some formatting problems, which created scanning issues; therefore, CMS is allowing the utilization of either the CMS 1500 (8-05) or the old CMS 1500 (12-90) until further notice by your payors.

One of the limitations of the CMS 1500 (12-1990 Version) is that it can not accommodate both the legacy and the NPI numbers in the same item box, in addition to this it is not capable of reading the ten digit NPI number. Both of these limitations result in an inability to test the transmission capability of the NPI number while using the legacy number as a safeguard. The 1990 Version also doesn’t incorporate several other changes made to the Physician/Supplier section of the form which, when the contingency period is halted, will result in rejected claims.

You should review your 8-2005 Version of the CMS 1500 to check the alignment. To do so you should verify that the arrow in the right upper corner is ¼ inch from the top of the page; if the arrow is less than that it might compromise accurate scanning.

Please note, that during the grace period you should make every attempt to convert to the correct 8-2005 form and test your claims transmission with your payers.

Please go to this link to access the National Uniform Claim Committee’s Instructions for completing the 8-2005 CMS 1500 form:National Uniform Claim Committee (Instructions CMS 1500)

5-21-07