- ABN Modifiers
- American Medical Association and Current Procedural Terminology
- CMS Forms and Publications
- CMS Regional Offices
- Clinical Lab Improvement Amendment
- Comprehensive Error Rate Testing
- Electronic Health Records
- Electronic Prescribing
- Evaluation and Management Documentation Guidelines
- Federal Register
- Health Insurance Portability and Accountability Act of 1996
- Interactive Voice Response System
- Limitation of Liability (Advance Beneficiary Notice of Noncoverage)
- Local Coverage Determination
- Medically Unlikely Edits
- Medicare Coverage Database
- Medicare Electronic Data Interchange
- Medicare Fraud and Abuse
- Medicare Learning Network®
- Medicare Provider-Supplier Enrollment with NGS
- NGS Internet Resources
- NGSConnex Online Web Application Can Save Time and Money
- NGS Check Provider Enrollment Application Status Tool
- National Correct Coding Initiative
- National Coverage Determination
- National ICD-10-CM-PCS: The Next Generation of Coding
- National Provider Calls and Events
- National Provider Identifier
- National Provider Identifier Registry
- National Uniform Claim Committee
- Open Door Forums
- P.O. Box Mailing Addresses
- Patient Protection and Affordable Care Act of 2010
- Physician Quality Payment Program
- Provider Contact Center
- Provider Enrollment
- Reconsideration (Second Level of Appeal)
- Recovery Audit Program
- Redetermination (First Level of Appeal)
- Skilled Nursing Facility Consolidated Billing
- U.S. Government Printing Office
- Washington Publishing Company
Limitation of Liability (Advance Beneficiary Notice of Noncoverage)
Services denied as not reasonable and medically necessary, under section 1862(a) (1) of the Social Security Act, are subject to the Limitation of Liability (ABN) provision. The ABN is a notice given to beneficiaries to convey that Medicare is not likely to provide coverage in a specific case. Providers must complete the ABN and deliver the notice to affected beneficiaries or their representative before providing the items or services that are the subject of the notice.
The ABN must be verbally reviewed with the beneficiary or his/her representative and any questions raised during that review must be answered before it is signed. The ABN must be delivered far enough in advance that the beneficiary or representative has time to consider the options and make an informed choice. ABNs are never required in emergency or urgent care situations. Once all blanks are completed and the form is signed, a copy is given to the beneficiary or representative. In all cases, the provider must retain the original notice on file.
Visit Beneficiary Notices Initiatives (BNI) for instructions and the ABN Form (CMS-R-131).
Reviewed 10/13/2023