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Home health agencies (HHAs) are responsible for issuing the following beneficiary rights and protections notices to Original Medicare (fee for service) beneficiaries when notice is required:

•   Home Health Change of Care Notice (HHCCN)
•   Advance Beneficiary Notice of Noncoverage (ABN)
•   Notice of Medicare  Non-coverage (NOMNC)
•   Detailed Explanation of Non-coverage (DENC)

The HHCCN, Form CMS-10280, is used to notify Original Medicare beneficiaries receiving home health care benefits of plan of care changes.  HHAs are required to provide written notification to beneficiaries before reducing or terminating an item and/or service. 

August 2016:  The Home Health Change of Care Notice (HHCCN), Form CMS-10280, and form instructions have been approved by the Office of Management and Budget (OMB) for renewal. While there are no changes to the form itself, providers should take note of the newly incorporated expiration date in the form instructions.

To download the HHCCN and its corresponding instructions, please click on the links below under "Downloads".


Questions regarding the HHCCN, ABN, NOMNC and DENC can be emailed to