Updated Advance Beneficiary Notice of Noncoverage (ABN) — Action Required by May 12, 2026
- HC Intellect
- Mar 14
- 3 min read
Date: March 15th, 2026
To: All Practices Billing Original Medicare FFS
From: Compliance & Coding Department
Subject: Updated Advance Beneficiary Notice of Noncoverage (ABN) - Action Required by May 12, 2026
Key Deadline: Practices must transition to the updated ABN (CMS-R-131) no later than May 12, 2026. Using an expired ABN after that date eliminates your ability to bill the patient if Medicare denies the claim - the loss becomes a mandatory write-off.
Background
The Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, is the required notice that providers - including physicians, practitioners, and DMEPOS suppliers - must issue to Original Medicare (fee-for-service) beneficiaries when Medicare payment is expected to be denied. Issuing a valid ABN transfers potential financial liability to the beneficiary and is a prerequisite for collecting payment from the patient when Medicare will not pay. For in-house brace-dispensing pain management practices, the ABN is frequently used when a patient’s clinical situation or coverage history creates a risk of Medicare denial for orthotic items billed under DMEPOS. The ABN is the legal instrument that shifts financial liability from the practice to the patient - but only when a valid, current form is used. If a practice issues an expired or otherwise invalid ABN and Medicare subsequently denies the claim, the practice cannot bill the patient for that service. The cost must be absorbed entirely by the practice. There is no workaround: an invalid ABN means the liability transfer never occurred.
What Changed
On March 13, 2026, the Office of Management and Budget (OMB) approved a new control number for the ABN (CMS R-131). CMS has posted the updated form on its website and notified the industry through the Medicare Learning Network. The updated ABN:
• Is effective immediately as of March 13, 2026
• Carries a new OMB expiration date of March 31, 2029
• Replaces the previously approved version, which is now considered expired
Transition Timeline
CMS has established the following transition window:
• March 13, 2026 – May 11, 2026: Either the expired or updated ABN form may be used.
• May 12, 2026 and beyond: Only the updated CMS-R-131 form is acceptable. If an expired ABN is used on or after this date and Medicare denies the claim, the practice cannot bill the patient - the loss must be written off entirely.
Recommended Action Steps
HCI recommends the following steps for all brace-dispensing practices:
• Download the updated ABN (CMS-R-131) from the CMS website immediately.
• Replace all printed ABN stock with the updated form - both in the office and in any electronic or EHR based ABN workflows.
• Update any internal templates or patient intake documents that reference or include the ABN to ensure the correct form version is in use.
• Train front desk and billing staff on the updated form and the May 12, 2026 mandatory transition date.
• Do not issue the expired ABN form for any services rendered on or after May 12, 2026.
CMS Resource
— End of Memo —
HC Intellect is a Milwaukee-based healthcare revenue cycle management (RCM) and technology firm with a deep specialization in interventional pain management and related surgical specialties. The company partners closely with pain practices and ASCs to optimize coding, billing, and collections across the full revenue cycle, with particular expertise in complex procedure coding, E&M optimization, and payer-specific reimbursement challenges unique to interventional pain. By combining experienced RCM teams with proprietary analytics and AI-driven tools, HC Intellect helps pain practices reduce denials, accelerate cash flow, and sustainably improve financial performance.
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