DecisionHealth, DecisionHealth - 2026 Issue 4 (April)

Courtesy ABNs dominate, missed ABNs rise, and denials for GA dip sharply

Providers are most likely to issue an advance beneficiary notice of non-coverage (ABN) for services that are excluded from Medicare coverage. For the years 2020 to 2024 providers submitted approximately 574 million claims with modifier GY (Item or service statutorily excluded or does not meet the definition of any Medicare benefit).

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