The NY State Workers' Compensation Board has ruled out that effective July 1st, 2022, providers would need to use the CMS-1500 claim form for medical bills submission. This decision has been made to simplify this process and relieve providers from a significant portion of the paperwork. The following claim forms will no longer be accepted if billed for services related to an injury received at work:
- Doctor's Initial Report (C-4, EC-4)
- Continuation to Carrier/Employer Billing Section (C-4.1)
- Doctor's Progress Report (C-4.2, EC-4.2)
- Ancillary Medical Report (C-4AMR, EC-4AMR)
- Doctor's Narrative Report (EC-4NARR)
- Occupational/ Physical Therapist's Report (OT/PT-4, EOT/PT-4)
- Psychologist's Report (PS-4)
- Ophthalmologist's Report (C-5)
At the same time, each form must be submitted with a detailed narrative report & medical record.
It is noteworthy that many commercial Workers' Compensation payers have already accepted the CMS-1500 forms.
