NPI
The National Uniform Claim Committee (NUCC) announces the release of the new version of the CMS-1500 Health Insurance Claim Form (version 08/05) that accommodates the reporting of the National Provider Identifier (NPI). This new version will update the existing CMS-1500 Claim Form (version 12/90), often referred to as the HCFA-1500.
What you need to know about the new CMS-1500 (REV. 08/05)
Here are frequently asked questions regarding the NEW CMS-1500 Claim Form
A. Why is it changing?
The CMS-1500 contains a number of improvements and enhancements that include better alignment with the electronic HIPAA ASC X12N 837-non Institutional Transaction Standard. The New CMS-1500 paper claim form will be able to accommodate the reporting of the National Provider Identifier (NPI) Number. The NPI will be a single provider identifier replacing the different provider identifiers healthcare systems currently use for each health plan with which you do business. The NPI Identifier, which implements a requirement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), must be used by all HIPAA covered entities, which are health plans, healthcare clearinghouses, and healthcare providers.
At this time, there has been no change to the NUCC's recommended timeline for transitioning to the revised form. The timeline remains.
B. What are the timelines for the transition for the new CMS-1500 Claim Form?
- October 1, 2006: Health plans, clearinghouses, and other information support vendors must be ready to handle and accept the revised (08/05) 1500 Claim Form.
- October 1, 2006 - March 31, 2007: Providers can use either the current (12/90) version or the revised (08/05) version of the CMS-1500 Claim Form.
- April 1, 2007: The current (12/90) version of the CMS-1500 Claim Form is discontinued; only the revised (08/05) form is to be used. All rebilling of claims should use the revised (08/05) form from this date forward, even though earlier submissions may have been on the current (12/90) 1500 Claim form.
- Providers will need to check with their payer and/or clearinghouses to determine when they will begin to accept the revised forms.