US · guidance
CMS Pub. 100-04, ch. 24, § 90.4
Electronic and Paper Claims Implications of Mandatory
Electronic Submission
(Rev. 2803, Issued: 10-28-13, Effective: 09-17-13, Implementation: 09-17-13)
Claims providers submit via a DDE screen maintained by a Medicare shared system or
transmitted to an A/B MAC or DME MAC using the free/low cost claims software issued
by Medicare are considered electronic. When enforcing the electronic claim submission
requirement, CMS will take into account those limited situations where a provider
submitted paper claims because the free billing software they were issued may have been
temporarily unable to accommodate submission of a secondary or other particular type of
claim.
A/B MACs and DME MACs are prohibited from requiring submission of paper claims in
any situations on or after October 16, 2003, except as specifically permitted by CMS.
A/B MACs and DME MACs are to assume for processing purposes that claims submitted
by a provider on paper October 16, 2003, and later are submitted by providers that are
small or that do meet exception criteria, barring information received from other sources
to the contrary. Submission of a paper claim October 16, 2003, or later will be
considered an attestation by a provider that waiver criteria are met at the time of
submission.
History
(Rev. 2803, Issued: 10-28-13, Effective: 09-17-13, Implementation: 09-17-13)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
90c67a9d6d83b05f7792dbbc40f0c56e66f8b02784e4da0f01641f27547e3d7a
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