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New CMS 1500 Form

Starting April 1, 2014, providers in California must use a new CMS 1500 form when submitting bills for treatment provided to injured workers.  The transition period has come and gone, so throw out any old CMS 1500 forms you still have.  All workers compensation bills must now be submitted using the CMS 1500 Health Insurance Claim Form (version 02/12).  

This new form looks very much like the old form so be sure to look for the correct version number (02-12) on the bottom right corner:

If you're a DaisyBiller, don't worry about about this change of forms--we've got you covered and will take care of it on our end.  If you aren't a DaisyBiller, the new forms are available at the official government bookstore, as well as at many other web and brick and mortar stores.

We anticipate a period of some confusion as everybody, providers and claims administrators alike, transitions to the new form.  For more information, consult Section 1.0 CMS 1500 (on pp. 18-19) of the California DWC Medical Billing And Payment Guide, Version 1.2.

Originally published on Petal to the Metal and migrated to this blog upon the merger of the two blogs.