Are You Using the New 2026 ABN Form?

Ensure you’re using the updated Medicare ABN form correctly. It applies only to Part B, not Advantage plans. Use it at the right time, keep it current, and avoid overuse to stay compliant.

Referenced Links:

ICS Article with Examples
Note: links to various versions of the ABN form can be found at the bottom of this article (i.e., large print and Spanish).
New ABN Form

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Transcript:

We want to remind our members that just a little over a month ago was the deadline to begin using the new Medicare ABN form, and it is important to know that that ABN form is only good for Medicare Part B. You should not, in fact, you can not use the ABN form, the official CMS ABN form for Medicare Advantage plans. If you have a Medicare Advantage plan patient and you are a participating provider with that Medicare Advantage plan, you’ve got to find out what they require. They may have their own specific advance notice requirement for covered services that you believe are not going to be reimbursable, and so that’s important. Contact each one of the individuals; they have their own forms.

And then on the other side of this is the is that new ABN form. Make sure that you’re using the new ABN form. It is, it’s imperative to make that change. I’ll include a link down below, both to the new ABN form, as well as an article that we put out several months ago, just giving you that heads up and that warning that it was out. So that is the first thing. Make sure you make that change. The second thing is this is, remember when you use an ABN form, if you’re using it on every visit, Medicare says that that form is is unduly alarming the patient and is no longer valid, which basically means it’s like you never got it signed to begin with, and so you want to use one, the right form, you’ve got to have the right form; two use it at the right time, so when is that right time? Whenever you’re beginning a new maintenance care episode, that is when an ABN form has to be signed. So, if a patient’s in active treatment, right, they’re in active care or an AT modifier on your claim form. Obviously, there is no Medicare ABN form at that moment. In fact, if you had one signed before that, the moment you begin active treatment, that old form is now dead. You’ve got to get a new one signed, and so if you start a new episode of maintenance care, so you don’t get it when you’re doing the active treatment, only newly switch back to maintenance care after active treatment.

So that’s the first key. Now the other is it’s only good for 12 months, so you either need to have this perfect system that reminds you to get an updated ABN form that’s already 12 months old, or there’s an alternative, and the alternative is this: anytime somebody is moving from active treatment to maintenance, you get an AB informed signed immediately. The second time that you would have them sign it is the first visit for all of your maintenance care patients of a calendar year that always ensures that your previous ABN form that would be expired after 12 months is now updated, and you don’t have to have this perfect system in your office to ensure that you are reminded to get an updated ABN form randomly throughout the year for all of your different patients. It’s a more difficult process to track those things, so if you just have a policy in place in your practice where new episode of maintenance care, you get an ABN form signed, and for your maintenance patients only, and that’s super important for your maintenance patients only, at the beginning of the calendar year, you have them sign a new ABN form, and that ensures that your ABN forms are always fresh and up to date, and not unduly alarming the patient.

Check out the links that are down below to give you access to that ABN form, as well as an article that covers it. The article also has some examples. Thank you to Dr. Mario Fucinari for providing us with those examples of what that form will look like when it’s filled out. We’ll catch you next week.