Updated: Sep 13
It is time for the latest release and mandatory implementation of the updated ABN form for Medicare.
This time, the big change to the form is the expiration date.
The use of the renewed form with the expiration date of 01/31/2026 will be mandatory on 6/30/23. You may continue to use the ABN form with an expiration date of 6/30/23 until the renewed form (expiration date 01/31/2026) becomes mandatory on 6/30/23.
***FAQs Regarding the ABN for Medicare***
What is an ABN?
An ABN is an Advance Beneficiary Notice of Noncoverage. (Form CMS-R-131)
When is an ABN required?
The ABN must be provided to the patient when you expect that Medicare will not pay for a covered service. For Chiropractors, this applies only to spinal manipulation.
With this form, the patient can make a decision about whether or not to continue to receive care and accept financial responsibility based on the understanding that the service will not be reimbursed by Medicare.
Are Chiropractors REQUIRED to use the ABN?
Can I get an Advance Beneficiary Notice (ABN) signed once for each patient, and have it apply to all services and all visits?
No. The decision to deliver an ABN must be based on a genuine reason to expect that Medicare will not pay for a particular covered service on a specific occasion for that beneficiary due to a lack of medical necessity for that service.
How long is a signed ABN good for?
The ABN can be used for a period of visits or time frame, but not to exceed one year.
Once an ABN has been signed it is valid until the patient has a new injury or exacerbation. At that point, the ABN is void, as a new condition has occurred and the patient will be placed back on active care. Another ABN must be provided once the patient progresses from that period of active care to maintenance/supportive care.
Is an ABN required for Non-Covered services?
It is not required that you use an ABN for services and therapies NOT covered by Medicare. However, it might be beneficial in certain cases.
For more information on Medicare Documentation for Chiropractic, including more about the ABN, click below to request a training session!
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