Medi-Cal Transmitions to CMS-1500 form and NPI

From April 23, 2007 to June 24, 2007, Medi-Cal will accept both the HCFA 1500 and CMS-1500 form. Providers using the HCFA 1500, however, can only enter their Medi-Cal provider number. Providers may choose to fully transition to the new CMS-1500 claim form at any time during this two-month period before the use of the CMS-1500 becomes mandatory. Beginning June 25, 2007, Medi-Cal will only accept the CMS-1500.

Also, beginning May 23, 2007, the NPI, if available, should be reported along with the Medi-Cal provider number, but is not necessary for proper adjudication. The Medi-Cal provider number must be reported on all claims through November 25, 2007. Claims received with only an NPI will not be processed. Beginning November 26, 2007, providers must use only an NPI when submitting CMS-1500 claims to Medi-Cal.