Skip to Main Content

FFS HHABN

September 9, 2013 -  Home Health Change of Care Notice (HHCCN) and Advance Beneficiary Notice of Non-coverage (ABN) released for Home Health Agency (HHA) Use

Mandatory Date of Use: December 9, 2013

The HHCCN, Form CMS-10280, and the ABN, Form CMS-R-131, are available for HHA use and are posted in the download section below.  HHAs may begin using these notices immediately. These notices will replace the Home Health Advance Beneficiary Notice (HHABN), Form CMS-R-296, issued to Original Medicare (fee for service) beneficiaries. 

For items and services provided on or after December 9, 2013, the HHABN will no longer be valid, and HHAs must use the ABN and HHCCN.  HHABNs issued prior to December 9, 2013 for ongoing, repetitive services will remain in effect for the time period indicated on the notice, up to one calendar year from the date of issuance. Please note that, like the HHABN, the ABN is effective for up to one year and must be issued annually for ongoing, repetitive services when notice is required.

The table below gives a brief description of situations requiring notice and lists the proper replacement notice.

HHAs must provide notice:

Instead of:

Use:

prior to providing an item or service that is usually paid for by Medicare but may not be paid for in this particular case because:

  • it is not considered medically reasonable and necessary;
  • the care is custodial;
  • the individual is not confined to the home; or
  • the individual does not need intermittent skilled nursing care.

HHABN

Option Box 1

ABN

(CMS-R-131)

prior to the HHA reducing or discontinuing care listed in the beneficiary’s plan of care (POC) for reasons specific to the HHA on that occasion.

HHABN

Option Box 2

HHCCN 

(CMS-10280)

prior to the HHA reducing or discontinuing Medicare covered care listed in the POC because of a physician ordered change in the plan of care or a lack of orders to continue the care.

HHABN

Option Box 3

HHCCN

(CMS-10280)

This table is for general reference purposes only. HHAs should refer to Change Request (CR) 8403 and CR 8404 for Centers for Medicare & Medicaid Services (CMS) guidelines.

 

Email questions regarding the HHCCN and ABN to: RevisedABN_ODF@cms.hhs.gov