Health Information Management

CMS releases an improved Advance Beneficiary Notice

Briefings on APCs, May 1, 2008

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In a much anticipated move, CMS released its new Advance Beneficiary Notice (ABN) of Noncoverage March 3. Hospitals must use this form (also known as the ABN-R-131) for all Medicare Part B provider and supplier services.

The form replaces the existing ABN-G and ABN-L forms, and hospitals may also use it for voluntary notifications in place of the Notice of Exclusion from Medicare Benefits (NEMB). It does not replace the SNFABN-G form, which is currently under development.

According to CMS, important new features of the form include:

  • A new official title to convey the purpose of the notice more clearly
  • A mandatory field for cost estimates of noncovered items/services
  • A new beneficiary option that allows an individual to choose to receive an item or service and pay for it out of pocket, rather than have a claim submitted to Medicare

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Briefings on APCs.

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