The Advanced Beneficiary Notice or ABN is a form that has been around for a long time. It is important to be aware that the Centers for Medicare and Medicaid (CMS) has just recently updated the form. The new SNF ABN form and instructions are now published and are available for immediate use. The new form will be mandatory for use on 10/31/2024.
Click here for the New ABN Instructions.
The new form has been updated to better align with Medicare policies. Key changes include:
- Improvements in layout of the form
- Language has been updated to help clarify the consequences of signing or not signing the form.
- The revised form includes more precise information about potential costs that beneficiaries might incur if Medicare does not pay for certain services.
- The signature and date fields have been reformatted to emphasize the importance of completing these sections accurately.
Skilled Nursing Facilities (SNFs) must issue a notice to Original Medicare (fee for service – FFS) beneficiaries in order to transfer potential financial liability before the SNF provides an item or service that is usually paid for by Medicare but may not be paid for in this particular instance because it is not medically reasonable and necessary, or for custodial care. For Part A items and services SNFs use the SNF ABN as the liability notice.
SNFs are not required to give written notice prior to providing care that Medicare never covers, such as care that is statutorily excluded or care that fails to meet a benefit requirement; however, as a courtesy to the beneficiary and to forewarn him/her of impending financial obligation, SNFs are encouraged to give notice.
For Part B items and services: SNFs use the Advance Beneficiary Notice of Non-coverage (ABN), Form CMS-R-131.
Refer to the Medicare Claims Processing Manual, Chapter 30, Section 70 for general notice requirements and detailed information on the SNF ABN. Information on the ABN (Form CMS R-131) can be found on the ABN webpage: CMS ABN
If you have any questions about using the ABN form please contact Kay Hashagen at [email protected] or (410) 777-5999.