An important update by the New York State Workers’ Compensation Board
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.