Federal Requirements

Medicare Advance Beneficiary Notice

Physicians may incur financial liability for services if the physician knew, or should have known, that Medicare fee-for-service would not pay for the specific service and fails to have the patient sign the proper Advanced Beneficiary Notice form prior to rendering service. Physicians are expected to use the revised ABN (ABN Form CMS-R-131), which shows “March 2011” printed in the lower left hand corner. Additional information and instructions may be viewed on CMS’ website.

E/M Guidelines (1995 v. 1997)

Centers for Medicare & Medicaid Services (CMS) Evaluation and Management Services Guide



AMA’s National Health Insurer Report Card


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