The Fee for Service Advance Beneficiary Notice of Noncoverage (ABN) form – known as Form CMS-R-131 – has been revised. Physicians, suppliers, labs, and other practitioners were required to begin using the new ABN form no later than June 21, 2017.
Get the revised ABM forms in English and Spanish.
How and When to Use the ABN Form
The Centers for Medicare and Medicaid Services (CMS) requires that the ABN notice be given to Medicare beneficiaries to convey that Medicare is not likely to provide coverage in a specific case. The form is issued by physicians, practitioners, suppliers, and providers such as independent laboratories, home health agencies, and hospices.
The ABN notice must be provided to and reviewed with beneficiaries prior to the delivery of items or services, with enough advance notice so that the beneficiary has time to make an informed choice. Once delivered, a copy of the ABN notice must be kept on file.
ABNs are not required in emergency or urgent care situations.
CMS offers detailed instructions on Form CMS-R-131 here.