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Revised Form CMS-R-131 Advance Beneficiary Notice of Noncoverage

Prior to March 3, 2008, providers, practitioners, and suppliers paid under Part B as well as hospice providers and religious non-medical health care institutions paid under Part A were instructed to use the general Advance Beneficiary Notice (ABN-G) or laboratory Advance Beneficiary
Notice (ABN-L) to inform beneficiaries of their potential liability in accordance with the limitation on liability provisions set forth in Section 1879 of the Social Security Act. Beginning on March 3, 2008, CMS implemented use of the revised Advance Beneficiary Notice of Noncoverage (ABN). The revised ABN combines the ABN-G and the ABN-L into a single notice, with the same form number (CMS R-131).

Download the Guidance Document

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: September 05, 2008

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.