FFS Revised ABN (as stated by CMS.gov)
The revised Advanced Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, is issued by providers (including independent laboratories), physicians, practitioners, and suppliers in situations where Medicare payment is expected to be denied. The revised ABN replaces the ABN-G (Form CMS-R-131G), ABN-L (form CMS-R-131L), and NEMB (Form CMS-20007). See the revised ABN manual instructions below for detailed instructions on mandatory and voluntary use of the revised ABN.
Note: Skilled nursing facilities (SNFs) must use the revised ABN for items/services expected to be denied under Medicare Part B only.
September 20, 2011: Extension of mandatory use date for REVISED ABN, FORM CMS-R-131, posted for download on May 16, 2011. Mandatory use date: January 1, 2011.
The latest version of ABN (with the release date of 3/2011 printed in the lower left hand corner) is now available for immediate use and can be accessed via the link below. In order for providers and suppliers to have time to transition to using the newly posted notice, mandatory use of this version begins on January 1, 2012. All ABNs with the release date of 3/2008 that are issued on or after January 1, 2012 will be considered invalid.
The mandatory use date has been changed from September of 2011 to January of 2012 to accommodate those providers and suppliers with pre-printed stockpiles of ABNs so that they have additional time to exhaust their supplies of the outgoing ABN.
The newest version of ABN and the instructions for use can be downloaded at the following page: