CMS Updates the ABN. What Home Health Agencies Need to Know Now!
Effective May 12, 2026, home health agencies must begin using the updated Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131 with the new expiration date of 03/31/2029.
The previous ABN form version (expiration date 01/31/2026) is no longer valid for notices issued on or after May 12, 2026.Agencies continuing to use the expired form risk having the notice deemed invalid, which may prevent the agency from holding the beneficiary financially responsible if Medicare denies payment.
Although the updated form includes readability and formatting enhancements, the purpose, content, and instructions for use remain largely unchanged.
CMS ABN resource: CMS Advance Beneficiary Notice of Noncoverage (ABN) Resources
Details:
The Advance Beneficiary Notice of Noncoverage (ABN) is used when a provider believes Medicare may not pay for a service or item. The notice informs the beneficiary of potential financial responsibility before services are provided.
For home health agencies, ABNs commonly arise in situations such as:
Services not considered reasonable and necessary
Frequency or duration exceeding Medicare coverage expectations
Noncovered supplies or items
Care that does not meet homebound or skilled need criteria
Services provided after coverage criteria are no longer met
Therapy or nursing services expected to be denied
What Changed?
CMS released an updated ABN form:
Form: CMS-R-131
New expiration date: 03/31/2029
Mandatory implementation date: May 12, 2026
CMS allowed providers to continue using the prior version through May 11, 2026. However, beginning May 12, 2026:
The old form is obsolete
New notices must use the updated version
Expired ABNs may be considered invalid
Why This Matters for Home Health Agencies
If a home health agency issues an outdated ABN after May 11, 2026:
The notice may not protect the agency financially
The beneficiary may not be held liable for denied services
The agency may have to absorb the cost of denied claims
Surveyors, auditors, and Medicare contractors may identify this as a compliance deficiency
This change impacts multiple departments, including:
Intake and admissions
Clinical field staff
Therapy departments
Billing and revenue cycle teams
Compliance and quality departments
EMR/document management teams
While the update may seem minor, CMS expects immediate operational compliance with the revised form requirements.
Your Next Steps
1. Download the Updated ABN Form Immediately
Ensure your agency is using the updated CMS-R-131 form with the expiration date of 03/31/2029.
2. Remove All Expired ABN Forms
Conduct a full review of:
Admission packets
EMR libraries
Shared drives
Paper forms in clinician bags
Desktop templates
Mobile documentation systems
Discard all obsolete ABNs to prevent accidental use.
3. Verify EMR and Vendor Updates
Confirm your EMR vendor or IT department has:
Uploaded the updated ABN
Removed outdated templates
Updated workflows and automated documentation processes
4. Educate Staff Immediately
Provide focused education to:
Intake personnel
Nurses and therapists
Clinical managers
Billing staff
Compliance teams
Education should include:
The mandatory implementation date
How to identify the correct form
Appropriate ABN use in home health
Risks associated with invalid notices
5. Audit Current ABN Practices
Perform spot audits to verify:
Only current ABNs are being issued
Documentation supports ABN issuance
Staff understand coverage-related triggers for ABNs
