The Medicare Advance Beneficiary Notice of Noncoverage (ABN) form expired on January 31, but CMS and Medicare Administrative Contractors (MACs) have confirmed that providers should continue using the current version until an updated form is released.

The ABN (Form CMS-R-131) is used to notify Medicare beneficiaries when a provider believes Medicare is likely to deny coverage for a service, allowing the patient to decide whether to proceed and accept potential financial responsibility.

The current ABN has technically expired, CMS has not yet released an updated version. This situation occurs periodically and has historically followed the same process.

CMS states directly on its Beneficiary Notices webpage:

"These notices may expire prior to the Office of Management and Budget (OMB) approval … providers and plans may continue using the current version of the notice after the expiration date … Providers and plans will have 60 calendar days from the date of the CMS notification to begin using the updated notice."

Some MACs have already issued notices confirming this approach and instructing providers to continue using the existing form until further notice (CGS, Noridian).

Contact the APMA Advocacy Department with any questions at [email protected].