New Medicare ABN Form Mandatory June 21, 2017

The Centers for Medicare and Medicaid Services (CMS) has revised the Advanced Beneficiary Notice of Non-coverage (ABN) Form. The revised Advanced Beneficiary Notice of Non-coverage (ABN), Form CMS-R-131, is issued to the patient or client by providers, physicians, practitioners, and suppliers in situations where Medicare payment is expected to be denied. The revised ABN replaces the ABN Form that was last released in November 2011.

When a physician or supplier has a “genuine doubt” that a service will be covered, they are required to notify the patient of this fact. The ABN form is required to be used for a service that is covered. In the Medicare program, chiropractic coverage is limited to coverage for spinal manipulation by means of the hands or hand-held device. For all non-covered services, a standard letter informing the patient of the non-coverage or the ABN may be used.