Medicare ABN revised form required August 31, 2020

The delayed update to the Advance Beneficiary Notice (ABN) has finally arrived. The revised form will be mandatory on August 31, 2020, with the older version acceptable until that date. The updated form and instructions can be found in the document library of Digital Coding under the Medicare tab. Network members may also email sam@hjrossnetwork.com to get copies as well. There is an English and Spanish version available.

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 will be mandatory on 8/31/2020.  

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).