All New York workers’ compensation providers should rejoice. The New York Workers’ Compensation Board (NY WCB) now mandates that claims administrators reimburse providers up to $1.00 per bill for their e-billing costs.

When sending a CMS-1500 electronically using a WCB-approved Submission Partner, the NY WCB instructs providers to add billing code CPT 99080 to each e-bill to obtain the reimbursement. The CPT 99080 charge should reflect the actual cost of submitting the bill electronically, up to a one-dollar maximum.

daisyBill Bonus: For New York clients, daisyBill automatically adds CPT 99080 as a line item to every electronic CMS-1500 for provider services sent from our billing software.

Below are further details about CPT 99080 reimbursement.

CPT 99080: Offset e-Billing Costs

Effective August 1, 2025, New York providers treating injured workers must send the CMS-1500 (aka HCFA) electronically to the payer using a WCB-approved Submission Partner. The provider’s chosen WCB-approved Submission Partner sends the e-bill data to the WCB in a defined XML format.

Providers may add CPT 99080 to the e-bill to reflect up to one dollar in fees paid to the provider’s chosen WCB-approved Submission Partner.

All New York providers should immediately embrace e-billing as the administrative and mailing savings are substantial. The monetary arithmetic is simple:

1. Providers no longer pay the printing, paper, and envelope costs to mail two paper bills to the payer and the WCB.
2. Providers no longer pay postage fees to send paper bills to the payer and WCB ($0.73 x 2 =$1.46).
3. e-Billing provides verified proof of delivery for each bill, drastically reducing the need for duplicate bills.
4. Faster payment
5. Providers electronically receive Explanations of Review (e-EORs, also known as e-EOBs), significantly reducing the administrative costs of manually posting payment details.

Providers do not have to wait until e-billing becomes mandatory in August. Providers who currently e-bill may use CPT 99080, as described below. WCB Subject Number 046-1707 (pictured below) offers additional details, including (emphasis ours):

• Providers should place 99080 “on the same CMS-1500 form for which the billable services payment and the electronic submission costs are being requested.”
• The price for code 99080 should “accurately reflect the actual cost incurred by the provider for the electronic submission of the individual bill, up to a maximum of one dollar.”

Automatic CPT 99080 Charge

To streamline e-billing for New York providers, daisyBill billing software automatically adds CPT 99080 and a $1.00 charge to every physician CMS-1500 e-bill. Staff does not need to take action to collect this e-bill reimbursement.

This CPT 99080 charge appears once a daisyBiller saves a new e-bill; however, a client may delete the charge.

What if the payer denies CPT 99080?

Per the WCB's instructions, payers must reimburse providers for appropriate CPT 99080 charges that accurately reflect the cost of submitting the e-bill.

If a payer fails to properly reimburse CPT 99080, the WCB urges providers not to file a Request for Decision on Unpaid Medical Bill(s) (Form HP-1.0). Instead, the WCB instructs providers to gather multiple instances of improper 99080 denials and report them in batches to the WCB.

daisyBill will monitor and report payers’ failure to reimburse CPT 99080 to the WCB on behalf of our New York clients. Our software will automatically document such payment denials, and our agents will contact the WCB to report payers who routinely refuse to compensate appropriately (yep, daisyBill protects New York providers).

For any questions regarding soon-to-be-mandatory e-billing for New York workers’ comp, our experts are here to help clients and non-clients alike. Reach out using the chat feature on this screen, or email us at info@daisybill.com 

For the best e-billing results, use the best tech. Schedule a chat with daisyBill about making a smooth transition before August 2025.

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