Medicare Beneficiary Notices Initiative (BNI) FFS SNF ABN
Guidance for SNFs for issuing a notice to Original Medicare (fee for service - FFS) beneficiaries in order to transfer potential financial liability.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: September 19, 2019
What's New
08/28/2024: With the help of our contractors, we revised the SNF ABN, Form CMS-10055, and the form instructions. The SNF ABN form and instructions are located in the download section and are available for immediate use, but will be mandatory for use on 10/31/2024.
Skilled Nursing Facilities (SNFs) must issue a notice to Original Medicare (fee for service - FFS) beneficiaries in order to transfer potential financial liability before the SNF provides:
- 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
- custodial care.
For Part A items and services: SNFs use the SNF ABN as the liability notice.
For Part B items and services: SNFs use the Advance Beneficiary Notice of Non-coverage (ABN), Form CMS-R-131. The ABN and information on this notice can be found at /Medicare/Medicare-General-Information/BNI/ABN.
To download the SNF ABN and accompanying instructions, please click on the appropriate link below.
Questions?
Questions regarding the SNF ABN or ABN can be submitted at: https://appeals.lmi.org/
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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.