CMS Issues Revised SNF ABN Form and Instructions

September 16, 2024-- Skilled Nursing Facilities (SNFs) must issue an Advanced Beneficiary Notice (ABN) to Original Medicare Beneficiaries in order to transfer potential financial liability when:

• an item or service that is usually paid for by Medicare, but may not be paid for in this particular instance because it is not medically reasonable and necessary, or
• in the instance where the care has become custodial

For Part A items and services: SNFs use the ABN as the liability notice. The SNF ABN provides information to the patient so they can decide whether or not to get care that may not be paid for by Medicare.

CMS has recently revised the SNF ABN, Form CMS-10055, and the form instructions. 

What you should know:

• The revised SNF ABN form is available for immediate use.
• SNFs must use the SNF ABN when applicable for SNF Prospective Payment System services (Medicare Part A).
• The SNF ABN is only issued if the beneficiary intends to continue services and the SNF believes the services may not be covered under Medicare. 
• The new ABN will be mandatory for use on 10/31/2024.    

Questions regarding the SNF ABN or ABN can be submitted to the CMS Division of Appeals Policy. 

To see the full CMS announcement, visit this link.