CMS-1500 Mandate August 1 Deadline: What NY Physicians Need to Know
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New York physicians treating workers’ compensation patients must prepare for a critical regulatory shift. Effective August 1, 2025, the NYS Workers’ Compensation Board will require all CMS-1500 forms to be submitted electronically via a Board-approved submission partner. Failure to comply may result in non-payment, as payers will be permitted to deny reimbursement for paper submissions.
Each individual provider, not just the practice, must comply. MSSNY urges members to act now to prevent disruption to claims and ensure timely payments. Some approved partners can convert paper forms to electronic formats on your behalf, offering a transitional solution. Practices currently working with a clearinghouse should confirm if it is integrated with an approved submission vendor.
To help offset costs, providers may use CPT code 99080, reimbursable up to $1 per bill, as long as it’s used correctly. The Board will host free webinars through July to guide providers on the mandate and answer questions.
For full details and compliance resources, visit wcb.ny.gov/CMS-1500. MSSNY remains committed to helping you navigate regulatory changes—join today for tools, advocacy, and expert support.
Questions? Email [email protected].
