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The Centers for Medicare & Medicaid Services (CMS) mandated that on January 1, 2012, the standards for electronic health care transactions must change from version 4010/4010A1 to version 5010/5010A1. This includes claim submissions through the HIPAA interface with EIM/ESM.

Refer to the information and links below for more details about the EIM/ESM's implementation of the 5010 standards.

  • Companion Guide Ver. 8 pdf format of    Companion Guide Ver. 8  doc format of HIPAA 5010 Companion Guide file size 2MB 2.49MB (Updated 11/22/2011)
    Important! The Enterprise Invoice Management/Enterprise Service Management Companion Guide to HIPAA Compliant Electronic Data Interchange Transactions has been updated for 5010. The Companion Guide provides clarification for how to use 5010 within the EIMESM system. The Companion Guide does not take the place of the CMS Implementation Guide which provides the rules of HIPAA compliancy.
  • 005010 HIPAA Implementation Guides
  • HIPAA Standards
  • Additional EIM/ESM HIPAA Information

Need Assistance?

  • If you have questions about 5010 as it relates to your software vendor, clearinghouse, or billing intermediary, please contact them.
  • If you have any questions about EIM/ESM 5010 send your inquiry to EHS-DL-EIM-ESMBusinessOperations@massmail.state.ma.us or contact Virtual Gateway Customer Service at 1-800-421-0938 (TTY: 617-847-6578).

This information is provided by the Virtual Gateway within Health and Human Services.