Revised ABN Notice

Effective Date: September 1, 2008. Implementation Date: March 3, 2008

On Monday, March 3, 2008, CMS will implement use of the revised Advance Beneficiary Notice of Noncoverage (ABN) (CMS-R-131). This form replaces the General Use ABN (CMS-R-131-G), and the Lab ABN (CMS-R-131-L) for physician ordered laboratory tests. The form and notice instructions will be posted on the Beneficiary Notice Initiative web page. Updated manual instructions and the Spanish version of the form on the BNI web page will be posted in the near future.

Some key features of the new form are that it:

• Has a new official title, the “Advance Beneficiary Notice of Noncoverage (ABN)”, in order to more clearly convey the purpose of the notice;
• Replaces both the existing ABN-G and ABN-L;
• May also be used for voluntary notifications, in place of the Notice of Exclusion from Medicare Benefits (NEMB);
• Has a mandatory field for cost estimates of the items/services at issue; and
• Includes a new beneficiary option, under which an individual may choose to receive an item/service, and pay for it out-of-pocket, rather than have a claim submitted to Medicare.

CMS will allow a 6-month transition period from the date of implementation for use of the revised form and instructions. Thus, all providers and suppliers must begin using the new ABN (CMS-R-131) no later than September 1, 2008. Questions about the new ABN may be sent to RevisedABN_ODF@cms.hhs.gov