Services always excluded from Medicare don't require special billing notice

August 1, 2008

Services that have never been covered by Medicare don't require an ABN modifier in order to bill the patient.

Key Points

We routinely provide services to our Medicare patients that are listed as "non-covered." We were told we must now supply the patient with an ABN, even if the service has never been covered by Medicare. Is this correct?

No. Services that have always been excluded from Medicare coverage do not require an ABN in order to bill the patient. You may wish to inform your patients - possibly with a handout - if you provide services excluded from Medicare coverage (routine vision exams, certain cosmetic procedures, etc.) that states they are services not covered by Medicare. It's also not necessary to bill the services with the ABN modifiers.