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FFS SNFABN and SNF Denial Letters

Skilled Nursing Facilities (SNFs) must issue a liability notice to Original (fee for service) Medicare beneficiaries 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 may use either the Skilled Nursing Facility Advance Beneficiary Notice (SNFABN) or one of the five SNF denial letters as the liability notice.

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

To download these notices and accompanying instructions, please click on the appropriate link below.