Awareness : OBC Tips

When to Issue an ABN

Issue an Advanced Beneficiary Notice (ABN) of non-coverage to patients when:

  • Patients are enrolled in original (fee-for-service) Medicare
  • Medicare may not cover because it is not medically reasonable and necessary for the diagnosis and/or treatment.
  • Providing more than the number of services that Medicare allows in a specific period for the corresponding diagnosis.
  • Not excluded under another provision of the Medicare Program.