Using the ABN for Medicare Advantage Plans

April 9, 2018
 / 
Rick Gawenda
 / 

The Advance Beneficiary Notice of Non-Coverage (ABN) is used when normally the service(s) or item(s) would be covered by the Medicare program, but under the circumstance, a provider does not think their Medicare Administrative Contractor will pay for a service(s) or item(s). A question I have been receiving lately is can a provider of outpatient therapy services use an ABN for Medicare Advantage (MA) plans to indicate to the MA plan that they (the provider) believe the MA will not pay for a service(s) or item(s)?

The ABN is to be used

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