New Medicare notice of noncoverage form available now, must be used as of June 30

The Centers for Medicare & Medicaid Services has approved a renewed Advance Beneficiary Notice of Noncoverage form (CMS-R-131). The only change to the form is the expiration date, which is now Jan. 31, 2026. You may start using the renewed form now, but its use is not required until June 30, 2023, when the previous version expires.

Physicians and others typically give patients on traditional (fee-for-service) Medicare an Advance Beneficiary Notice of Noncoverage, or ABN, form when Medicare is expected to deny payment (e.g., because Medicare doesn’t cover the patient’s diagnosis, or the service is being provided more frequently than Medicare covers). The ABN is issued to transfer potential financial liability to the Medicare beneficiary in certain instances. You can find guidelines for issuing an ABN beginning in Section 50 in the Medicare Claims Processing Manual, 100-4, Chapter 30 (PDF). 

— Kent Moore, AAFP Senior Strategist for Physician Payment

Posted on April 6, 2023