Medicare Advance Beneficiary Notice of Noncoverage

“An ABN is a written notice a health care provider gives to a Medicare beneficiary when the provider believes that Medicare probably or certainly will not pay for some or all of the items or services.”

This FAQ addresses the following:

1. What is Medicare’s Advance Beneficiary Notice of Noncoverage (ABN) and why do I need one?
2. When should we use an ABN?
3. If I am planning an extended course of treatment, must I get an ABN each time?
4. Do I always need an ABN if I know Medicare will not pay?
5. May I modify the ABN form?
6. How do I complete the form?
7. What else should I know about completing the form?
8. What happens if I don’t get a signed ABN form and Medicare denies my claim?
9. Must I submit a claim?
10. Does the ABN form work for Medicare Advantage (Part C) plans and private payers?

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