Fee For Service Advance Beneficiary Notice of Noncoverage
The Advanced Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, is issued by providers (including independent laboratories), physicians, practitioners, and suppliers to Original Medicare (fee for service) beneficiaries in situations where Medicare payment is expected to be denied. Guidelines for mandatory and voluntary use of the ABN are published in the Medicare Claims Processing Manual, Chapter 30, Section 50.
Note: Skilled nursing facilities (SNFs) must use the ABN for items/services expected to be denied under Medicare Part B only.
September 9, 2013 Updates:
- Home Health Agencies (HHAs) may now use the ABN in place of the Home Health Advance Beneficiary Notice (HHABN), Option Box 1, Form CMS-R-296. Please check the HHABN web page for more information on the discontinuation of the HHABN and notice requirements for HHAs.
- Chapter 30, Section 50 of the Medicare Claims Processing Manual is updated in CR 8404 to address ABN use by HHAs, issuance of the ABN for therapy services, and minor editorial clarifications.
- ABN Form instructions were updated to include HHA issuance.
The ABN and the ABN form instructions are posted below under "Downloads". The latest version of the ABN has the release date of 3/2011 printed in the lower left hand corner. Mandatory use of this version began on January 1, 2012. All ABNs with the release date of 3/2008 that are issued on or after January 1, 2012 are considered invalid.
Questions regarding the ABN can be emailed to RevisedABN_ODF@cms.hhs.gov .
- Page last Modified: 09/18/2013 7:47 AM
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