Effective August 1, 2025, the New York State Workers’ Compensation Board (WCB) will no longer accept paper CMS-1500 medical billing forms. All providers must submit these forms electronically through a Board-approved electronic submission partner, or risk nonpayment.

If your practice treats injured workers in New York, now is the time to transition to compliant electronic billing. Here's what you need to know to stay ahead of the curve.

What’s Changing?

• The WCB is moving to a fully electronic submission process for the CMS-1500 form. The mandate includes:
• Mandatory electronic submission of all CMS-1500 forms for workers' compensation claims
• Elimination of paper billing—submissions received by paper after August 1, 2025 will not be processed or paid
• Use of WCB-approved electronic submission partners for all transmissions

New Requirements for Providers

Submit Electronically Through a Board-Approved Partner: You must use one of the WCB’s approved electronic submission vendors to send CMS-1500 forms.

Include a Medical Narrative Report: Each CMS-1500 form must be accompanied by a detailed medical narrative. The WCB offers a template to standardize the required information.

Offset Costs with Code 99080: Providers may bill code 99080 (administrative reports) to offset the cost of electronic submission—up to $1.00 per bill.

Why This Matters

Failing to comply with the new requirements will directly impact reimbursement:

• Claims administrators are not required to pay paper submissions.
• Paper CMS-1500 forms will be automatically rejected by the WCB.
• Timely, accurate electronic submissions mean faster payments and fewer delays.

Why Electronic Billing Is a Win

In addition to ensuring compliance, moving to an electronic process brings real business benefits:

• Faster Payments: Claims process and pay out more quickly
• Reduced Admin Work: No more printing, mailing, or tracking down lost paper
• Fewer Errors: Electronic systems check for formatting and code issues
• Better Visibility: Acknowledgments confirm delivery and help track rejection

How Claim.MD Helps You Stay Compliant

At Claim.MD, we’re ready to support your transition to electronic CMS-1500 billing for New York Workers’ Comp. With a simple, affordable platform and responsive customer support, we offer:

Connectivity to all major payers, including NY Workers' Comp administrators

• Tools for attaching medical narratives
• Support for billing code 99080 reimbursement
• Resources and guidance to ensure compliance before August 1

We have also added special pricing specifically for you: https://www.claim.md/pricing

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Resources for Providers:

WCB CMS-1500 Initiative Overview: Provides comprehensive information on the CMS-1500 electronic submission requirements. NYS Workers Compensation Boardblog.daisybill.com+17GovDelivery+17NYS Workers Compensation Board+17

List of Approved Electronic Submission Partners: A directory of Board-approved partners for electronic submissions. NYS Workers Compensation Boarddatadimensions.com+14NYS Workers Compensation Board+14NYS Workers Compensation Board+14

Medical Narrative Report Template: A template to assist providers in creating the required medical narrative. NYS Workers Compensation Boardblog.daisybill.com+9NYS Workers Compensation Board+9NYS Workers Compensation Board+9

Provider Webinars: The WCB offers webinars to educate providers on the new requirements and processes. NYS Workers Compensation BoardGovDelivery+17blog.daisybill.com+17blog.daisybill.com+17