Skip to Main Content

You are using an outdated browser. Please upgrade your browser to improve your experience.

Medicare Billing: CMS-1450 & 837I

Other Exceptions

Medicare automatically waives providers from the electronic claim submission requirement who experience 1 of the following unusual circumstances:

  1. Dental claims
  2. Disruption in electricity, phone, or communication services for more than 2 business days
  3. Claims from a larger provider that rarely treats Medicare patients, submitting less than 10 claims a month and not more than 120 claims per year

If your self-assessment indicates that any of these circumstances applies to you, you’re automatically waived from the electronic claim submission requirement. You can submit the CMS-1450 paper claim for the claim type shown or the time period when an unusual situation occurs.

Some of these situations are temporary or apply only to some claims. When the temporary situation expires or when billing other types of claims, you must submit your claims electronically in the HIPAA and Administrative Simplification standard format.