Tuesday, April 3, 2018

CMS Issues Changes to the Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNF ABN)

Sara Rudow 


On March 30, 2018,  the Centers for Medicare & Medicaid Services (CMS) issued Transmittal 4011, with CMS Medicare Claims Processing Manual changes revising the Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNF ABN), Form CMS-10055

With this revision, CMS is discontinuing the 5 SNF Denial Letters and the Notice of Exclusion from Medicare Benefits (NEMB-SNF), Form CMS-20014; the revised SNF ABN replaces the formerly used SNF ABN, the 5 SNF Denial Letters, and the NEMB.

SNFs must use the revised SNF ABN to inform beneficiaries of their potential liability for Part A items or services that may be denied effective April 30, 2018. However, SNFs can implement use of the new form prior to that date. 

Instructions on the use of Form CMS-10055 can be accessed here.

SNFs will continue to use the ABN, Form CMS-R-131, for items or services that may be denied by Medicare paid under Medicare Part B to inform beneficiaries of their potential liability.

These changes are effective April 30, 2018.
Note that use of the revised SNF ABN is addressed in the requirements and interpretive guidance under F-582, Medicare/Medicaid Coverage/Liability Notice, which can be found here.

The transmittal is available here.

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