Providers
With the CMS-1500 submission mandate, as of August 1, 2025, the NYS Workers' Compensation Board is requiring health care providers, regardless of office size or patient population, to submit the CMS-1500 universal medical billing form electronically through a Board-approved electronic submission partner.
To make the process as easy as possible, as of July 28, 2025, the Board removed the requirement for providers to log into the Medical Portal and accept the "Agreement for electronic submission of CMS-1500" before working with a submission partner.
After August 1, 2025, the Board will not act on, or enforce payment of, paper CMS-1500 forms and workers' compensation payers can deny them, which means the submitting provider will not be paid. To ensure uninterrupted payment for services, the Board urges all providers to transition to electronic submission now.
Electronic submission partner
Businesses who would like to register to become an electronic submission partner must first register with the Board and will be required to successfully pass XML testing prior to their approval to submit XML data to the Board. Once the registration is received and eligibility to participate verified, the electronic submission partner will be required to sign and return the testing legal agreement. The Board will notify the electronic submission partner by email, at the email address provided on the registration, that the registration has been approved and testing can begin. Once the electronic submission partner has successfully passed testing, the Board will notify the electronic submission partner by email that they have been approved for production submissions and require the electronic submission partner to sign and return a production legal agreement.
Additional information regarding becoming an electronic submission partner and the testing process.
Payers
The electronic process, prescribed by the Chair, requires payers to partner with at least one Board-approved electronic submission partner to transmit and accept health care provider medical bills via Electronic Data Exchange (EDI), or another format agreed upon with the electronic submission partner.
Payers must designate with the Board the electronic submission partner(s) from whom they accept medical bills. The payers' Medical Portal Online Administrators must keep electronic submission partner information accurate and update the online administrator application with any changes within three (3) business days. Detailed instructions on updating electronic submission partner designations can be found on the Designating an Electronic Submission Partner page.
A list of approved electronic submission partners for the CMS-1500 is posted on the CMS-1500 Electronic Forms Submission section of the Board's website and is updated after each entity successfully completes testing and executes an Electronic Submission Partner Agreement with the Board.
Please contact the WCB Online Services Technical Support Unit if you have technical questions regarding adding an electronic submission partner.