Notice Regarding the Revised Form CMS-1500

March 15, 2007

Notice Regarding the Revised Form CMS-1500

It has recently come to CMS? attention that there are incorrectly formatted versions of the revised CMS-1500 (08-05) form being sold by print vendors, specifically the Government Printing Office (GPO). Given the circumstances, CMS has decided to extend the acceptance period of the Form CMS-1500 (12-90) version beyond the original April 1, 2007, deadline while this situation is resolved. Medicare contractors will continue to accept the Form CMS-1500 (12-90) until notified by CMS to cease. At present, CMS is targeting June 1, 2007, as that date.

In addition, during the interim, Medicare contractors will return, not manually key, any Form CMS-1500 (08-05) forms received which are not printed to specification. By returning the incorrectly formatted claim forms, providers will become aware of the situation, which will allow them to begin communications with their form supplier.