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Skilled Nursing Facilities (SNFs) must issue a notice to Original Medicare (fee for service - FFS) beneficiaries in order to transfer potential financial liability 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
  • custodial care.

For Part A items and services: SNFs use the SNF ABN as the liability notice.

For Part B items and services: SNFs use the Advance Beneficiary Notice of Non-coverage (ABN), Form CMS-R-131. The ABN and information on this notice can be found at

To download the SNF ABN and accompanying instructions, please click on the appropriate link below.


Questions regarding the SNF ABN or ABN can be submitted at: