Medicare FFS ABN Renewal Form Changes 2017

Did you Know?

March 2017: The ABN, Form CMS-R-131, and form instructions have been approved by the Office of Management and Budget (OMB) for renewal.

What is the purpose of the ABN Form?

The Advance Beneficiary Notice of Non-coverage (ABN), Form CMS-R-131, is issued by providers (including independent laboratories, home health agencies, SNF (Part B) only and hospices), physicians, practitioners, and suppliers to Original Medicare fee-for-service (FFS) beneficiaries in situations where Medicare payment is expected to be denied

ABN Renew Form Changes – Effective June 21, 2017

  • The ABN revised form is now available for download and will be required to use beginning 06/21/2017
  • Newly Incorporated form CMS-R-131 (expiration date 3/2020) located in the footer
  • The form has been revised to include language informing beneficiaries of their rights to CMS nondiscrimination practices and how to request the ABN in an alternative format if needed
  • Otherwise, there are no other changes to the form itself

The revised form and detailed guidance can be located under the CMS “Beneficiary Notices Initiative (BNI),” web page at: https://www.cms.gov/MEDICARE/medicare-general-information/bni/abn.html. Under this site you will find the most current ABN and ABN form instructions under “Downloads.”

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