What is an ABN?
Medicare requires that if a physician or laboratory knows a test will not be covered by Medicare, they must inform the patient in writing prior to drawing or performing the test. This is called an “Advance Beneficiary Notice” (ABN). The patient must also be informed as to the reason Medicare will not pay for the test.
An ABN is a written notice a provider gives a Medicare beneficiary before items or services are furnished when the provider believes that Medicare probably or certainly will not pay for some or all of the items or services on the basis of medical reasonableness and necessity [Social Security Act §1862(a)(1)] and custodial care [Social Security Act §1862(a)(9)].
