INFORMATION ALERT: CMS Changes Medicare ABN Submissions

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INFORMATION ALERT:
CMS Changes Medicare ABN Submissions

The Centers for Medicare and Medicaid will require a single, new form for Advance Beneficiary Notices (ABN) for payment of non-covered services.

Revised Form CMS-R-131 Advance Beneficiary Notice of Noncoverage

The Centers for Medicare and Medicaid have issued an information alert regarding the use of new forms for ABNs, effective immediately.

What You Need to Know

Prior to March 3, 2008, physicians paid under Part B were instructed to use the general Advance Beneficiary Notice (ABN-G) or laboratory Advance Beneficiary Notice (ABN-L) to inform beneficiaries of their potential liability in accordance with the limitation on liability provisions set forth in Section 1879 of the Social Security Act.

Beginning on March 3, 2008, however, CMS implemented use of the revised Advance Beneficiary Notice of Noncoverage (ABN). This revised ABN combines the ABN-G and the ABN-L into a single notice, with the same form number (CMS R-131).

You should be aware that beginning March 3, 2008 and prior to March 1, 2009, your contractors will accept either the current ABN-G and ABN-L or the revised ABN as valid notification. However, beginning March 1, 2009, Medicare contractors will accept only a properly executed revised ABN (CMS R-131) as valid notification.