Last Update: March 19, 2026
The Centers for Medicare and Medicaid Services (CMS) has released the updated ABN form to replace the version that expired January 31, 2026. The Medicare Advance Beneficiary Notice (ABN) is routinely updated every 3 years, and the new ABN form should be used until its expiration on March 31, 2029.
You will note the new form design eliminated some of the clutter evident in previous forms and revised the wording in several sections, although requirements and responsibilities have not changed.
Dos and Dont's
You must issue an ABN:
- When a Medicare item or service isn’t reasonable and necessary under Program standards, including care that’s:
- Not indicated for the diagnosis, treatment of illness, injury, or to improve the functioning of a malformed body member
- Experimental and investigational or considered research only
- More than the number of services allowed in a specific period for that diagnosis
- CMS may hold you (the provider) financially liable if you don’t give the beneficiary an ABN for one of these specific situations.
- The ABN is not to be used for Medicare Advantage (Part C) items and services or the Medicare Prescription Drug Benefit (Part D).
- You don’t need to notify the beneficiary before you provide items or services that aren’t a benefit or never covered. Section 20.2 of the Medicare Claims Processing Manual, Chapter 30 has a list of Medicare non-covered items and services.
- CMS recommends you issue a voluntary ABN as a courtesy to alert the beneficiary about their financial liability.
- A minimum of two copies, including the original, should be made so the beneficiary and notifier each have one.
- Modifications of the ABN are prohibited except as specifically allowed by CMS instructions.
An ABN is valid only if you:
- Use the most recent CMS version approved by the Office of Management and Budget (OMB)
- Use a single ABN for an extended course of treatment for no longer than 1 year
- Complete the entire form
- Ensure the beneficiary understands the notice
What if the Beneficiary or their Representative Refuses to Choose an Option or Sign the ABN?
- If the beneficiary or their representative refuses to choose an option or sign the ABN, you should note that on the original ABN.
- You may list refusal witnesses, but it’s not required.
- If a beneficiary refuses to sign a correctly issued ABN, consider not providing the item or service unless the consequences (health and safety of the beneficiary or civil liability in case of harm) prevent it.
Resources
For MSN Clients
Please notify MSN when an ABN has been issued so we can add the appropriate modifier. Without that modifier, Medicare will not issue the correct denial code allowing us to bill the patient. Depending on information systems used, this data transfer process can vary so we have several options available to assist you. Please contact your Client Services Representative for any questions you may have.
And a final reminder...
Medicare does not allow the issuance of “blanket ABNs” to every patient. Each ABN must individually state why you believe the designated service may not be covered.
