On August 5, 2025, the Centers for Medicare and Medicaid Services (CMS) added a link on its website to its revised Advance Beneficiary Notice (ABN) Form and the associated instructions.  There are no substantive changes being proposed to the ABN Form.  Rather, the changes were limited to what CMS called “plain language and information design” changes.  These changes were recommended by the CMS Office of Communications, and reflect current best practices to ensure that forms and instructions are clear and easily understood by both health care providers and Medicare beneficiaries.

The ABN Form is used to inform Medicare beneficiaries of their potential financial liability under specific conditions.  The ABN Form is required whenever a health care provider or supplier has reason to believe that a particular item or service will not be covered under Medicare Program rules for that beneficiary on that particular date.  The ABN is intended to permit the beneficiary to make an informed decision on whether to receive the item or services under the circumstances.

The ABN is not required for denials of coverage that are based on a lack of medical necessity or other statutory coverage exclusion.  The ABN is only required when a denial is based on the item or service not being “reasonable and necessary to the treatment of the patient.”  As a result, the ABN form is rarely required for ground ambulance services.  

The revised form is currently pending approval from the Office of Management and Budget.  Once approved, CMS will formally announce both the effective date (expected to be February 1, 2026) and future expiration date for the revised ABN Form.  Until further notice, AAA members should continue to use the current ABN Form.