Updated Advance Beneficiary Notice (ABN) – Effective Through March 31, 2029
The Centers for Medicare & Medicaid Services (CMS) has released an updated Advance Beneficiary Notice (ABN) to replace the prior version that expired on January 31, 2026. The revised form is now valid through March 31, 2029.
The new version features a cleaner design, reduced clutter, and updated language throughout several sections. While the format has improved, the requirements and patient responsibilities remain unchanged.
Simply click the links below to download the latest versions:
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ABN Form Instructions (PDF) -
ABN Forms English and Spanish (Incl Large Print) (ZIP) -
ABN Alternative Format Sample for Labs (PDF)
When an ABN Is Required
An ABN must be issued when a Medicare-covered service (spinal CMT in chiropractic) is expected to be denied for reasons such as:
- Service is not medically necessary for the diagnosis or condition
- Service is experimental or investigational
- Service exceeds frequency or duration limits for the diagnosis
When an ABN is properly executed for spinal CMT, the claim should include modifier GA, indicating the patient has been notified and accepts financial responsibility.
Use of ABNs for Non-Covered (Excluded) Services
Although ABNs are intended for covered services that may be denied, they may also be used for statutorily excluded services (which includes most services in a chiropractic office aside from spinal CMT).
Examples of excluded services:
- Exams
- Therapies (e.g., massage, exercise)
- Adjunctive procedures
However, using ABNs in this context can create confusion for patients, since Medicare never covers these services.
Best Practice for Statutory Excluded Services
Many offices choose to use a Medicare financial policy or agreement instead of an ABN. This document clearly explains:
- What Medicare does and does not cover
- That certain services are never covered
- That the patient is financially responsible
This approach is often more straightforward and reduces misunderstandings.
Important Usage Rules
- ABNs may be used for both covered and excluded services
- Do not combine excluded services and non-covered spinal CMT on the same ABN
- If using ABNs for both scenarios, they must be issued separately
Sam’s Best Practice
- Use a financial policy/agreement for excluded services
- Reserve the ABN for spinal CMT when Medicare coverage criteria are not met
This approach minimizes confusion, strengthens compliance, and aligns with how Medicare reviewers interpret proper ABN usage.
Feel free to contact me with any questions
Samuel A. Collins
sam@hjrossnetwork.com