Advanced Beneficiary Notice (ABN) Update – DELAYED: Deadline for use pushed to 1/1/21

From CMS.gov 6/24/2020 – Beneficiary Notices Initiative:

Note: Skilled nursing facilities (SNFs) issue the ABN to transfer potential financial liability for items/services expected to be denied under Medicare Part B only.


The Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, is issued by providers (including independent laboratories, home health agencies, and hospices), physicians, practitioners, and suppliers to Original Medicare (fee for service - FFS) beneficiaries in situations where Medicare payment is expected to be denied. The ABN is issued in order to transfer potential financial liability to the Medicare beneficiary in certain instances. Guidelines for issuing the ABN can be found beginning in Section 50 in the Medicare Claims Processing Manual, 100-4, Chapter 30 (PDF).


The ABN, Form CMS-R-131, and form instructions have been approved by the Office of Management and Budget (OMB) for renewal. The use of the renewed form with the expiration date of 06/30/2023 was to have been eff no later than 8/31/2020. Due to COVID, the deadline for mandatory use has been pushed to 1/1/21. The ABN form and instructions may be found in the download section.



Questions:

Questions regarding the ABN can be submitted at: https://appeals.lmi.org/


Resources:

Please see downloadable resources:

ABN Form Instructions (PDF)

ABN-Form-Instructions
.pdf
Download PDF • 91KB

ABN Forms English and Spanish

ABNEnglish
.docx
Download DOCX • 27KB
ABNSpanish
.docx
Download DOCX • 30KB

ABN Alternative Format Sample for Labs (PDF)

ABN Alternative Format Sample Labs
.pdf
Download PDF • 87KB

In Addition: please find a link from Novitas providing an overview and snapshot:

https://www.novitas-solutions.com/webcenter/portal/MedicareJH/pagebyid?contentId=00108636


Please let us know if any questions or if we can help in any way. Wanted to make certain this found you prior to the original mandatory eff date of 8/31/2020 – Now 1/1/21.


Let's Get to the Point:

Advanced Beneficiary Notice (ABN) Update – DELAYED: Deadline for use pushed to 1/1/21