General Surgery Coding Alert - 2011 Issue 40
Reader Question: ABN Not Required for These Psychiatric Visits
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Article Overview
This reader question addresses Medicare billing and beneficiary notice requirements for outpatient psychiatric services. It explains the general relationship between non-covered services and the ABN process, and it highlights the updated CMS ABN form version and timing considerations that matter to practices, billing staff, and compliance teams.
Why This Topic Matters
Providers and billing staff need to know when an ABN is relevant, which services may shift financial responsibility to the patient, and how CMS form updates affect notice validity. The article helps practices avoid improper notice use and stay aligned with Medicare contractor expectations.
Article Sections
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Question
A reader asks about Medicare payment responsibility for psychiatric visits and whether a beneficiary notice is needed before billing the patient.
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Answer
The response discusses general Medicare handling of outpatient psychiatric services and the role of an ABN in relation to services that may be denied.
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Keep in mind:
This section notes the newer ABN form version, its CMS identification, and the timing of the form update.
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What will happen?
This section summarizes CMS guidance on the validity of older and newer ABN forms and the treatment of notices issued after the change date.
What You Will Learn
- How the article frames Medicare payment responsibility for outpatient psychiatric services
- When a beneficiary notice is generally discussed in connection with non-covered services
- What the article says about the updated CMS ABN form version and timing
- How the article characterizes the effect of using an older form after the update date
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Compliance staff
- Mental health providers
Codes Discussed
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