Advance Beneficiary Notice (ABN) Update

This article provides a practical update on the Advance Beneficiary Notice (ABN) form, which has been revised by the Centers for Medicare & Medicaid Services (CMS) and is now valid through March 2029. The author clarifies the specific use of this crucial document in a chiropractic office. An ABN is required when a Medicare-covered service—specifically spinal manipulation (CMT)—is expected to be denied for not being medically necessary. When properly signed, the claim is submitted with a GA modifier, transferring financial responsibility to the patient. A common area of confusion is the use of ABNs for statutorily non-covered services like exams, therapies, or X-rays. While technically permissible, the author strongly advises against this practice because it can confuse patients, as Medicare never covers these services anyway. The recommended best practice is to use a separate "Medicare financial policy" or agreement for all non-covered services. This document clearly states that these services are never paid by Medicare and that the patient is always financially responsible. By reserving the ABN strictly for potentially non-covered spinal CMT, chiropractic offices can minimize patient confusion, enhance compliance, and align with the intended purpose of the form.