New York Worker's Compensation - Update

Starting January 1, 2019, the New York state-specific treatment forms (such as PT-4) used for billing and reporting will be optional. Providers may replace these forms with the CMS-1500 form and a required Narrative Report.

To download an example PT/OT Narrative Report, click here.

What does this mean for you?

Your clinic can opt out of additional forms (such as PT-4) and provide a CMS-1500 and Narrative Report instead. 

What is required for a PT/OT Narrative Report?

Per the New York State Worker's Compensation Board:

• Rendering Provider's Name
• Referring Provider's Name
  • What was the frequency and period of the treatment ordered?
• Diagnosis(es) of Referring Provider
• Examination Findings
• (Re-)Evaluation/(Re-)Assessment of the patient's condition
  • Progress/Gains toward specific objective functional goals related to work or activities of daily living
  • Were identified goals met? If no, comment on the re-evaluation and/or change in treatment plan.
• Plan of Care
  • Treatment plan including a plan for the identification of ongoing specific objective functional goals and the re-evaluation of treatment.

For Psychologists, please see: Psychology Narrative Report

Can I submit the Narrative Report electronically?

While payers will start accepting Narrative Reports electronically, you are unable to accomplish this in the application. We are diligently working to create a tool to submit Narrative Reports electronically with your CMS-1500 forms. Electronic submission is not required until January 1, 2020.