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.
Note: Skilled nursing facilities (SNFs) must use the revised ABN for items/services expected to be denied under Medicare Part B only.
Download the ABN
The current version of the ABN and the instructions for use can be downloaded by clicking on the first link under "Downloads" below. This is the latest version of the ABN (with 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.
September 4, 2012
Revised manual instructions for the ABN are available and have been implemented with Change Request (CR) 7821. Chapter 30, Section 50 of the Medicare Claims Processing Manual was edited to simplify the presentation of existing information. Additional case specific scenarios and inclusion of ABN use for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) in relation to the Competitive Bidding Program (CBP) have been included. There have been no substantive changes to the policy, and there are no changes to the ABN with the release of these revised instructions.
Effective September 4, 2012, the revised section, as published in CR 7821, replaces the previously published version in the Medicare Claims Processing Manual and is available for download by clicking the "Revised ABN Manual Instructions" link under "Downloads" listed on this page.
Minor edits have been made in the ABN instructions to clarify that the provider/supplier is responsible for inserting wording in all of the blanks labeled “D” on the notice including the “D” blanks that are within the “Options” section. Please click the link in the list below to download the updated ABN instructions.
Questions regarding the ABN can be emailed to RevisedABN_ODF@cms.hhs.gov .
- Page last Modified: 04/10/2013 11:10 AM
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