CMS Extends Acceptance Period for Health Insurance Claim Form CMS-1500 (12-90)

On March 9, 2007, the Centers for Medicare & Medicaid Services (CMS) reported that it will extend the acceptance period for health insurance claim Form CMS-1500 (12-90).

In July 2006, Form CMS-1500 (12-90) was revised resulting in Form CMS-1500 (08-05).  In September 2006, CMS announced that it would implement Form CMS-1500 (08-05) on January 1, 2007 with dual acceptability of both versions until March 31, 2007.  Therefore, beginning April 1, 2007, Form CMS-1500 (08-05) was to be the only acceptable version of the form and the prior version, Form CMS-1500 (12-90), was to be rejected.

However, on March 9, 2007, CMS reported that there are incorrectly formatted versions (both printed forms and negatives) of Form CMS-1500 (08-05) being sold by print vendors, specifically the Government Printing Office.  Therefore, CMS reports that it has decided to extend the acceptance period of Form CMS-1500 (12-90) beyond the original April 1, 2007 deadline while this situation is being resolved.

Further, CMS will direct Medicare contractors to continue accepting Form CMS-1500 (12-90) until notified by CMS to cease. CMS is targeting June 1, 2007 as that date.  CMS also reports that Medicare contractors will be directed to return, not manually key, any Form CMS-1500 (08-05) forms that are not printed to specification.

CMS has stated that "[t]he best way to identify if your CMS-1500 (08-05) version forms are correct is by looking at the upper right hand corner of the form."  According to CMS, "[o]n properly formatted claim forms, there will be approximately a 1/4" gap between the tip of the red arrow above the vertically stacked word 'CARRIER' and the top edge of the paper."  However, "if the tip of the red arrow is touching or close to touching the top edge of the paper," CMS has indicated that "the form is not printed to specifications."

The actual CMS announcement extending the acceptance period of Form CMS-1500 (12-90) can be found on the CMS website as BREAKING NEWS! CMS-1500 (08/05).