Beneficiary Notices Initiative (BNI)
What's New
12/18/2025: The Office of Management and Budget (OMB) control number for the Medicare Outpatient Observation Notice (MOON) (CMS-10611) expired on November 30, 2025. CMS is coordinating with the OMB, in accordance with the Paperwork Reduction Act (PRA), to reauthorize this information collection. Once the OMB control number for the MOON is reauthorized, CMS will notify the industry through our website, the Health Plan Management System (HPMS), and the Medicare Learning Network. Providers may continue to use the current version of the notice until we provide further instructions. CMS will give providers 60 calendar days from the date of the CMS announcement to begin using the updated MOON.
The Office of Management and Budget (OMB) control number for the Important Message from Medicare (IM) (CMS-10065) and the Detailed Notice of Discharge (DND) (CMS-10066) expires on December 31, 2025. CMS is currently coordinating with the OMB, in accordance with the Paperwork Reduction Act (PRA), to reauthorize this information collection, however, we do not anticipate the control number’s reauthorization to occur prior to the expiration date. Providers may continue using the current version of the notices after the expiration date until CMS provides further instructions. Once the OMB control number for the IM and DND is reauthorized, CMS will notify the industry through our website, the Health Plan Management System (HPMS), and the Medicare Learning Network. Providers will have 60 calendar days from the date of the CMS announcement to begin using the updated IM/DND.
Beneficiary Notices Initiative
Both Medicare beneficiaries and providers have certain rights and protections related to financial liability and appeals under the Fee-for-Service (FFS) Medicare and the Medicare Advantage (MA) Programs. These financial liability and appeal rights and protections are communicated to beneficiaries through notices given by providers. Use the navigation links on the left side of this page or in the table below to access the financial liability, appeal and other notices and their instructions.
- FFS Advance Beneficiary Notice of Noncoverage (FFS ABN)
- FFS Home Health Change of Care Notice (FFS HHCCN)
- FFS Skilled Nursing Facility Advance Beneficiary Notice (FFS SNF ABN)
- FFS Hospital-Issued Notices of Noncoverage (FFS HINNs)
- FFS Expedited Determination Notices for Home Health Agencies, Skilled Nursing Facility, Hospice and Comprehensive Outpatient Rehabilitation Facility (FFS Expedited Determination Notices)
- MA Denial Notices (MA Denial Notices)
- MA Expedited Determination Notices (MA Expedited Determination Notices)
- Important Message from Medicare (IM) and Detailed Notice of Discharge (DND) (Hospital Discharge Appeal Notices)
- Medicare Outpatient Observation Notice (MOON)
- The Medicare Change of Status Notice (MCSN)
| Notice | Medicare Program | Type of Notice | Provider Type | Purpose | Link to Notice |
|---|---|---|---|---|---|
| Advance Beneficiary Notice of Non-coverage (ABN, Form CMS-R-131) | FFS | Financial Liability Notice | Healthcare providers (including independent laboratories, HHAs, and hospices), physicians, practitioners, and suppliers paid under Medicare Part B | Issued in order to transfer financial liability to beneficiaries to convey that Medicare is not likely to provide coverage in a specific case. | ABN, (ZIP)Form CMS-R-131 (ZIP)
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| Home Health Change of Care Notice (HHCCN, Form CMS-10280) | FFS | Care Changes | HHAs | Issued to beneficiaries receiving home health care benefits for notification of plan of care changes. |
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| Skilled Nursing Facility Advance Beneficiary Notice (SNF ABN, Form CMS-10055) | FFS | Financial Liability Notice | SNF | Issued in order to transfer financial liability to beneficiaries before the SNF provides an item or service that is usually paid for by Medicare, but may not be paid for in this particular instance because it is not medically reasonable and necessary, or is custodial in nature. |
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| Hospital-Issued Notices of Non-coverage (HINNs) | FFS *HINN 10 may be used for MA | Financial Liability Notices | Hospitals | Issued in order to transfer financial liability to beneficiaries if the hospital determines that the care the beneficiary is receiving, or is about to receive, is not covered in a specific case. There are currently four different HINNs. | HINNs (ZIP) |
| Notice of Medicare Non-Coverage (NOMNC, Form CMS-10123) | FFS & MA | Expedited Determination Notices | HHAs, SNFs, Hospices, and CORFs | Informs beneficiaries of their discharge when their Medicare covered services are ending. |
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| Detailed Explanation of Non-Coverage (DENC, Form CMS-10124) | FFS & MA | Expedited Determination Notices | HHAs, SNFs, Hospices, and CORFs | Given only if a beneficiary requests an expedited determination. Explains the specific reasons for the end of covered services. |
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| Important Message from Medicare (IM, Form CMS-10065) | FFS & MA | Hospital Discharge Appeal Notices | Hospitals | Informs hospitalized inpatient beneficiaries of their hospital discharge appeal rights. | IM, Form CMS-10065 (ZIP) |
| Detailed Notice of Discharge (DND, Form CMS-10066) | FFS & MA | Hospital Discharge Appeal Notices | Hospital or MA Plan | Given only if a beneficiary requests expedited review of a discharge decision. Explains the specific reasons for the discharge. | DND, Form CMS-10066 (ZIP) |
| Integrated Denial Notice (IDN, Form CMS-10003) | MA | Denial Notices | Medicare Health Plans | Issued upon denial, in whole or in part, of an enrollee's request for coverage and upon discontinuation or reduction of a previously authorized course of treatment. | |
| Medicare Outpatient Observation Notice (MOON) | FFS & MA | Hospital notice of observation services and are not inpatients | Hospital or MA Plan | Issued to inform Medicare beneficiaries (including health plan enrollees) that they are outpatients receiving observation services and are not inpatients of a hospital or critical access hospital (CAH). |
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| Hospital Medicare Change of Status Notice (MCSN) | FFS only | Hospital notice advising appeal rights when reclassified by a hospital from an inpatient to an outpatient receiving observation services | Hospital | Hospitals must deliver the Medicare Change of Status Notice (MCSN) to all beneficiaries advising appeal rights when reclassified by a hospital from an inpatient to an outpatient receiving observation services. | MCSN, Form and Instructions (English), CMS-10868 (ZIP) MCSN, Translated Forms CMS-10868 (ZIP)
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Questions?
Questions regarding any of the Original Medicare (also called Fee for Service) BNI notices, the Medicare Advantage notices, and the MOON can be submitted at: https://appeals.lmi.org