HIPAA - Version 5010 Transactions in EIM/ESM

Information and instructions about EIM/ESM's implementation of the 5010 standards.
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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.

EIM/ESM companion guide to HIPAA compliant electronic data interchange transactions

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).

HIPAA job aids

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) job aids provide guidance on how to read and reconcile HIPAA Claims Files in EIM.