Health care providers in the workers' compensation system can enter CPT code 99080 on the CMS-1500 form to offset the cost of using a Board-approved electronic submission partner. (This was previously a "No Charge" (NC) code defined in the Official New York Workers' Compensation Medical Fee Schedule as "Special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form.")

No supporting documentation is required for using code 99080.

Code 99080 may be used as a "By Report" (BR) code, up to a maximum value of one dollar. The code should be placed on the same CMS-1500 form for which the billable services payment and the electronic submission costs are being requested. The amount entered for this code should reflect the actual cost incurred by the provider for the electronic submission of the individual bill — based on your agreement with your chosen electronic submission partner — up to a maximum of one dollar.

When adding code 99080 to the CMS-1500 form, input the last date the patient received services listed on the form (do not use the date of billing). Offset reimbursement is per single bill, not each date of service or each CPT code.

Note: This cost-offset code is already available to providers who currently submit CMS-1500 forms electronically via a Board-approved electronic submission partner.

Providers should email MDO@wcb.ny.gov to notify the Board's Medical Director's Office of payers who are not reimbursing for offset costs. This issue will then be referred to our Payer Compliance unit. If the original bill remains unpaid by the payer, providers may submit a Request for Decision on Unpaid Medical Bill(s) (Form HP-1.0) for the full amount of the bill, including the unpaid offset. Payers who do not properly reimburse health care providers for CPT code 99080 may be subject to penalties from the Board.