Providers may continue to use the expired form until May 12, 2026, but must transition to the new form after that.

As a reminder, the CMS-R-131 ABN form is for Med B patients only 

(The Med A SNF-ABN form which is called CMS-10055, was revised in Oct 2024 and has no new changes)

An ABN allows a patient to accept financial responsibility for a non-covered service.  

For Med B, it is typically used when skilled therapy ends secondary to being no longer clinically indicated, but the patient requests continued treatment. 

The ABN allows the patient to accept full financial responsibility for the services, or to ask the facility to first bill Medicare and pay only if services are denied.

It is important to note that the facility may only bill the patient if an ABN was provided prior to the provision of the non-covered services.  

The biller must then append a “GA modifier” to the billing to let Medicare know that the ABN was given. 

Revisions include minor changes and simpler language.

The ABN form is available in English and Spanish.

The new forms have been added to the Enhance Therapies’ website and common share.

To see the new forms and ABN instructions: https://www.cms.gov/medicare/forms-notices/beneficiary-notices-initiative/ffs-abn

If you have questions or need additional information, please email us at: Medicarequestions@enhancetherapies.com