HCFA 1550 & UB-92 Claim Forms Cutoff Date Extension

Beginning September 17, 2007, claims received on the old HCFA 1500 or UB-92 claim forms will be rejected and returned to the provider. Providers must submit claims on the new CMS-1500 or UB-04 claim form to avoid rejection. Medi-Cal implemented the use of the CMS-1500 and UB-04 claim forms on June 25, 2007. Unfortunately, some providers continue to submit claims on the old forms, so the Department of Health Care Services (DHCS) has authorized EDS, to continue processing claims submitted on the old HCFA 1500 or UB-92 claim forms for a limited time only. The old claim forms will continue to be processed and adjudicated appropriately only through September 16, 2007.