New CMS 1500 (Form 02/12)

New CMS 1500 Claim Form Approved

NUCC Approves Transition Timeline for Version 02/12 1500 Health Insurance Claim Form

Chicago, IL – The NUCC is pleased to announce the approval of the timeline for transitioning to the version 02/12 1500 Health Insurance Claim Form (1500 Claim Form).  In June, the NUCC announced the approval of the updated 1500 Claim Form that accommodates reporting needs for ICD-10 and aligns with requirements in the Accredited Standards Committee X12 (ASC X12) Health Care Claim: Professional (837P) Version 5010 Technical Report Type 3.

The NUCC approved the following transition timeline at its in-person meeting in Chicago, IL on August 1, 2013.

  • January 6, 2014: Payers begin receiving and processing paper claims submitted on the revised 1500 Claim Form (version 02/12).
  • January 6 through March 31, 2014: Dual use period during which payers continue to receive and process paper claims submitted on the old 1500 Claim Form (version 08/05).
  • April 1, 2014: Payers receive and process paper claims submitted only on the revised 1500 Claim Form (version 02/12).

This timeline aligns with Medicare’s transition timeline.

Additional information about the 02/12 1500 Claim Form is located on the NUCC’s website: www.nucc.org.  Resources available include a sample of the updated form, contact information for obtaining printer files and updated forms, a crosswalk between the updated version and current version of the form, the NUCC’s instruction manual for the updated form, and a map between the updated form and the ASC X12 837P.

About the NUCC

The 1500 Claim Form is maintained by the NUCC.  The NUCC is a voluntary organization of health care industry stakeholders representing providers, payers, designated standards maintenance organizations, public health organizations, and vendors.

For more information on the 1500 Claim Form, visit the NUCC website, www.nucc.org or email info@nucc.org.

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