Q:
When someone is still on Med A benefits and the therapy team reduces or ends one type of therapy but not all types, does the ABN need to be given each time?
A:
The notices aren’t required when therapy reduces or ends services, but rather when the SNF determines the beneficiary no longer has a daily skilled need. For Part A, the Notice of Medicare Non-Coverage (NOMNC, CMS-10123) is required when the SNF determines the beneficiary no longer requires daily skilled services and there are days remaining in the benefit period. The beneficiary, or authorized representative, should be notified no later than 2 days before termination of services. The SNF Advanced Beneficiary Notice (SNFABN, CMS-10055) is required when the beneficiary no longer requires daily skilled services and will remain in the facility.
For more information, the Beneficiary Notice Initiative webpage is located here: https://www.cms.gov/Medicare/Medicare-General-Information/BNI
