Medicare Advanced Beneficiary Notice Forms

Medicare does not cover all services that could be rendered to a Medicare-insured patient. In specific situations, a patient could elect to receive the services anyway if willing to pay out-of-pocket. The way to facilitate this process is with an Advanced Beneficiary Notice (ABN) form provided by Medicare. This video explains what an ABN is specifically used for, how to use it properly and why they are important.
Below you will find resource links specifically for this topic.
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RESOURCES:
ABN CMS Link: www.cms.gov/me...
ABN Form Instructions: www.cms.gov/me...
CMS ABN Tutorial: www.cms.gov/Ou...
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[@matthewwilliams911]

I've been told we have to issue an ABN form to all Part B therapy patient at time of D/C. Basically having them sign it saying they agree they don't want any further therapy. This does not make sense to me as it does not seem like the purpose of the form. Can you clarify this? If therapy has finished plan of care and patient is aware of D/C do you need to issue an ABN?

[@navigatingthebusinessofmed8251]

Hi there and thank you for asking. Let me start with telling you I’m not a certified biller or coder or worker in PT/OT/SPT, but I am not aware of this. You are correct in that is not what the form is intended if being used as you described. Also, there can be repercussions for clinics that use ABNs unnecessarily as well, so I would advise a deeper look into this with your MAC and the coverage guidelines. If they are using for the threshold amount being reached for a Medicare patient on the chance they can’t justify continuing therapy due to medical necessity and the patient wants to continue anyway, then I can see this. I would definitely research this further. Thank you for watching!