May 15, 2017

Providers Must Use New ABN Form

By Janet Potter, Senior Manager, Advisory Services

Providers Must Use New ABN Form

Recently the Centers for Medicare and Medicaid Services (CMS) updated the CMS-R-131 (ABN) form. As you know, providers are required to issue an Advanced Beneficiary Notice (ABN) to Medicare beneficiaries when those services provided are expected to be denied by Medicare.

For Part B services administered by physicians, practitioners, suppliers, laboratories, home health agencies, hospices, and skilled nursing facilities, this notification is done via the CMS-R-131. The updated form has no content changes and no procedural changes. However, the new form has an expiration date of 3/2020 in the lower left hand corner. Providers can begin to use the form immediately and are required to use the new form for all notices issued after June 21, 2017. Use of the old form after June 21 is equivalent to providing no notice or incorrect notice to beneficiaries and could lead to provider liability.

If your organization is struggling to issue the correct provider notices at the correct time, Marcum LLP can help. Please contact your Marcum LLP advisor.


View the new form on the CMS website.

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