The Advance Beneficiary Notice of Non-Coverage (ABN), Form CMS-R-131, and form instructions have been approved by the Office of Management and Budget (OMB) for renewal. The renewed form, which will expire on January 31, 2026, will become mandatory on June 30, 2023. Providers are permitted to continue using the ABN form with an expiration date of June 30, 2023, until the renewed form becomes mandatory this summer.

The ABN form is issued by Medicare providers, including independent laboratories, home health agencies, hospices, physicians, practitioners, and suppliers, to fee-for-service Medicare beneficiaries when Medicare payment is anticipated to be denied. The ABN is issued to transfer potential financial liability to the Medicare beneficiary in certain instances. Section 50 of the Medicare Claims Processing Manual (100-4, Chapter 30) provides guidelines for issuing the ABN.

Click here to access the renewed form and instructions (see "Downloads" section).