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Subject Number 046-1079 Board Announces Technical Specifications for CMS-1500 Initiative

Board Bulletins and Subject Numbers

July 16, 2018

As announced on April 17, 2018, in Subject Number 046-1058 Proposals to Improve Medical Care for Injured Workers, the New York State Workers' Compensation Board (Board) will replace the current Board treatment forms: Doctor's Initial Report (Form C-4), Doctor's Progress Report (Form C-4.2), Occupational/Physical Therapist's Report (Form OT/PT-4), Psychologist's Report (Form PS-4), and Ancillary Medical Report (Form C-AMR) with the CMS-1500 to help reduce paperwork and lower provider administrative burdens. This initiative will leverage providers' current medical billing software and medical records while promoting a more efficient workers' compensation system. It is expected that the initiative will roll out in three phases, as follows:

Phase 1: Commencing January 1, 2019:

Phase 2: On or about July 1, 2019:

Phase 3: On or about January 1, 2020:

Visit the CMS-1500 Initiative section of the website to access technical specifications for the CMS-1500 medical billing and associated acknowledgement data and to find periodic updates.

Please direct questions to

Clarissa M. Rodriguez