New CMS 1500 Implementation Reference Guide April 7, 2014 CMA, Medicare, Payment, Physician Resource CMS 1500 02-12, CMS 1500 0 SFMS/CMA surveyed the major payors in California to learn about each payor’s requirement for submitting the new CMS 1500 (2/12 version) for submission after April 1, 2014. With ICD-10 implementation delayed until October 2015, SFMS/CMA is awaiting additional information from CMS on whether there will be any changes to the new CMS-1500 form. Until that time, we recommend that providers continue to follow the previous guidance issued and implement as required. Payor Name Requiring new CMS 1500 form effective 4/1/2014* Additional Information Aetna No Will allow practices to submit either CMS 1500 (version 08-05 or 02-12) after April 1, 2014. Aetna will require the new CMS form (02-12) beginning October 1, 2014. More information can be found at aetna.com. Anthem Blue Cross Yes Require practices to submit new CMS 1500 (02-12) effective April 1, 2014. Any claims submitted on the old CMS 1500 form (08-05) will be rejected. Blue Shield of California No Will allow practices to submit either CMS 1500 (08-05 or 02-12) after April 1, 2014. Blue Shield will notify providers at a later date as to when they will require use of the new CMS 1500 form (02-12). More information can be found at Provider Connection - Blue Shield of California. Cigna No Will allow practices to submit either CMS 1500 (08-05 or 02-12) after April 1, 2014. Cigna will notify providers at a later date as to when they will require use of the new CMS 1500 form (02-12). More information can be found at cigna.com, select "healthcare professionals," then select "Newsletters." Health Net No Will allow practices to submit either CMS 1500 (08-05 or 02-12) until October 1, 2015.** Humana Yes Require practices to submit the new CMS 1500 (02-12) on April 1, 2014. Any claims submitted on the old CMS 1500 form (08-05) will be rejected. Medi-Cal Yes Effective April 1, 2014, DHCS will require practices to submit the new CMS 1500 form (02-12). Any claims submitted on the old CMS 1500 form (08-05) will be rejected. Medicare Yes Effective April 1, 2014, CMS require practices to submit the new CMS 1500 form (02-12). Any claims submitted on the old CMS 1500 form (08-05) will be rejected. United Healthcare Yes Require practices to submit the new CMS 1500 form (02-12) on April 1, 2014. Any claims submitted on the old CMS form (08-05) will be rejected. More information can be found at unitedhealthcareonline.com. *Information current as of March 19, 2014. **May be delayed until October 1, 2015 with new ICD-10 postponement. Please confirm with payor. Comments are closed.
