Deadline for Use of CMS 1500 (12-90) Claim Form
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Deadline for Use of CMS 1500 (12-90) Claim Form

Per Change Request 5616, Medicare contractors cannot accept CMS-1500 Claim Form version (12-90) after July 1, 2007.  Ensure that your staff is aware of the change deadline so you do not have claims rejected after this date.

The only acceptable claim form will be the CMS-1500 Claim Form version (08-05).  The last day contractors will accept CMS-1500 Claim Forms version (12-90) is June 29, 2007.  All claims submitted on the CMS-1500 Claim Form version (12-90) and received after June 29, 2007 will not be processed.  Therefore, it is recommended that you cease mailing this form June 25, 2007.

Noridian Administrative Services (NAS), a CMS DME MAC, provides additional information on how to correctly submit a CMS-1500 (08-05) claim form with the CMS-1500 Claim Form (08-05) interactive tutorial located on its website located at https://www.noridianmedicare.com/.  To access the tutorial, select the "Claims" tab from the drop down box beneath DME on the NAS homepage.  The tutorial is listed beneath the "Claims Filing Information" subtitle in the left hand column.

To use the tutorial, place the cursor over any item on the form and the instructions for completing the item will appear.  You may also select any item with the cursor for more detailed instructions.

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