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FFS ED Notices

HHAs, SNFs, Hospices, and CORFs are required to provide a Notice of Medicare Non-Coverage (NOMNC) to beneficiaries when their Medicare covered service(s) are ending.  The NOMNC informs beneficiaries on how to request an expedited determination from their Quality Improvement Organization (QIO) and gives beneficiaries the opportunity to request an expedited determination from a QIO.  A Detailed Explanation of Non-Coverage (DENC) is given only if a beneficiary requests an expedited determination.  The DENC explains the specific reasons for the end of services.

Download FFS Expedited Determination Notices and Instructions

January, 2015: New NOMNC and DENC form instructions available below, in ‘Downloads’.  Neither the NOMNC or the DENC form has changed, and providers may continue using the current forms.

Full instructions on the Original Medicare, also known as Fee for Service (FFS), expedited determination process are available in Section 260, of Chapter 30 of the CMS Claims Processing Manual, available below in ‘Related Links’.

To download the FFS Expedited Determination Notices and Instructions (the NOMNC and DENC), please click on the appropriate link below.