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  Guidelines for Medical Necessity For Limited Coverage Tests

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What is an Advance Beneficiary Notice (ABN)?

An ABN is a written notice from Medicare (standard government form CMS-R-131), given to the patient before receiving certain items or services, notifying them that:

  • Medicare may deny payment for that specific procedure or treatment.

  • The patient will be personally responsible for full payment if Medicare denies payment.
An ABN gives the patient the opportunity to accept or refuse the items or services and protects the patient from unexpected financial liability in cases where Medicare denies payment. It also offers the patient the right to appeal Medicare's decision.

Download an Advance Beneficiary Notice (ABN)

 

 

 



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