The Advance Beneficiary Notice is a standardized notice that the provider must issue to a Medicare beneficiary
prior to providing certain Medicare Part B items or services.
The ABN allows a beneficiary to make an informed decision about whether to allow a service
be performed and accept financial responsibility for those services Medicare does not pay.
The ABN lets the patient know ahead of time that the service you are
providing may not be considered medically necessary by Medicare.
The ABN will then also serve as proof that the beneficiary knew prior to receiving the
service that Medicare might not pay.
The Advance Beneficiary Notice is to be used for Fee for Service Medicare patients only.
It is not used for items or services provided under the Medicare Advantage (MA) Program
or for prescription drugs provided under the Medicare Prescription Drug Program (Part D).
You should check with those plans to see what would be appropriate for use.
Please take note of the release date and only use the current version.
Older versions will not be accepted
This most current version is located on the CMS website at www.cms.gov
To locate and download the ABN form; go to NGSMedicare.com and click on provider resources, click on forms then select coverage.
When you click on the form for Advance Beneficiary Notice of Non Coverage a pop up will appear
and ask if you would like to proceed to an external site.
click ok
You will then be redirected to the CMS website; where you will scroll down to the downloads
section and select ABN forms English and Spanish to download.
ABN forms instructions are also available to download for helpful tips.
Stay tuned to the National Government Services YouTube channel for future educational videos, designed for you.
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