The Advanced Beneficiary Notice of Noncoverage (ABN) has been updated by the Office of Management and Budget (OMB).  The use of the updated form with the expiration date of 1/31/26 will be mandatory on 6/30/2023. You may continue to use the ABN form with the expiration date of 6/30/23 until the renewed form (expiration date 1/31/26) becomes mandatory on 6/30/23.

For the renewed ABN form, and instructions, go to:
https://www.cms.gov/medicare/medicare-general-information/bni/abn

For instructions on when and how to use an ABN Form go to:
https://www.cms.gov/medicare/medicare-general-information/bni/downloads/abn-form-instructions.pdf

The ABN Form, CMS-R-131, is given to Medicare beneficiaries to sign when it is believed that Medicare will not pay for a particular service and that the patient will be required to cover the cost of the service. This usually happens when the service is thought not to be medically necessary, or the service is not a covered Medicare service.

The ABN MUST be reviewed with the beneficiary or his/her representative. You should go over all aspects of the ABN BEFORE it is signed. In addition, the ABN should be signed and in the possession of the clinic far enough in advance of the visit (the visit meaning the visit that the ABN has an effect on) so that the beneficiary or representative has time to consider all their options and make an informed choice.

Make sure once ABN is completed to give a copy to the beneficiary or representative and have the other copy in the patients file.