New ABN Mandatory 1/1/21

Effective 1/1/21, the CMS-R-131 Advanced Beneficiary Notice of Noncoverage (ABN) form will be required for the following 2 reasons:

1. Part B services: Resident requests services, but the facility determines the services are not medically necessary

2. Part B services are ending because: Therapy is no longer medically necessary, and resident indicates desire to continue therapy The Form and Additional information can be obtained through the below links provided by CMS:

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 /Medicare/Medicare-General-Information/BNI/ABN.

Questions:

Questions regarding the SNF ABN or ABN can be submitted at the Division of Appeals Policy Portal.

Downloads:

• Chapter 30 - Financial Liability Protections (PDF)

• SNF ABN 2018 (CMS-10055) (DOCX)

• SNF ABN 2018 (CMS-10055) (DOCX)

• SNF ABN (CMS-10055) Fillable PDF (PDF)

Related Links:

• Skilled Nursing Facility PPS

Let's Get to the Point:

Keeping you in the loop on this change in form with clarification of the indication for use on Part B only therapy services in the SNF.