PROVIDERS WHO CAN SUBMIT THE CMS 1500 PAPER FORM
- Small providers:
- Facilities (who file Medicare Part A claims) with fewer than 25 FTEs; OR
- Physicians/Practitioners/Facilities (who file Medicare Part B or DME claims) with under 10 FTEs
- Large providers who submit fewer than 10 claims on average to Medicare per month.
- Providers who have experienced disruption in electricity or phone/communication services.
- Non-Medicare Managed Care Organizations that bill Medicare for copayments.
There are other exceptions related to types of claims – including, for example, dental claims. And, of course, paper claims from patients are also accepted.
For more detail on any of these exceptions – including how to count FTE’s to qualify as a “small” provider – see Chapter 24 of the Medicare Claims Processing Manual, Section 90 (the relevant information starts on page 81).