Advance Beneficiary Notices of Non-coverage

Objective

To ensure that CUIMC clinicians properly deliver Advance Beneficiary Notice of Non-coverage (“ABNs”) to Medicare beneficiaries as required under Medicare regulations.

Policy

Medicare rules require that Medicare beneficiaries receive written notice before receiving certain services for which Medicare probably will not pay. An ABN is given before providing any service that could be deemed by Medicare to be not reasonable and necessary. An ABN generally is not required, however, for services that are statutorily excluded from Medicare coverage, such as cosmetic surgery.

All ABNs must be given using standardized forms that meet Medicare requirements. See Medicare Learning Network Booklet Medicare Advance Written Notices of Non-coverage for instructions on properly delivering an ABN form.

Office for Billing Compliance
Policy#: 10034
Original Date of Issue: 1996
Revised: 3/22/2023
Reviewed: 3/1/2024