ABN and NOMNC - Q and A Series: Part II


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Question and Answer Series

Part II

1. What is the Last Covered Day (LCD) that should be entered on the NOMNC for a patient not dually eligible for Part A and Hospice, who elects hospice? 


Enter the effective date that the patient will be responsible for payment, i.e., the first non-covered day. There may be times when the 2-day notice is not possible for example, the patient elects to end Part A and decides to elect Hospice benefit.

Technically speaking if the patient elects to end Medicare, the NOMNC is not required. 

2. Is NOMNC required for Medicare Part B therapy? 

Yes, the NOMNC must be provided to beneficiaries and/ or enrollees receiving Medicare Part B covered services, including but not limited to:

  • skilled nursing,
  • home health (including psychiatric home health),
  • *comprehensive outpatient rehabilitation facility, and
  • hospice services.


*The (CORF) is a medical facility that provides outpatient diagnostic, therapeutic, and restorative services for the rehabilitation of injury, disability, or illness.

CORF care is commonly known as outpatient rehabilitation care. 


3. Do you still give the NOMNC with the SNF ABN if an SNF resident chooses hospice immediately and the facility is unable to give a 48-hour notice?

In this scenario, the patient is driving the end of the Medicare Part A coverage due to the election of hospice.


The SNF ABN is important to identify the financial liability as the patient comes off Medicare Part A and will be responsible for room and board.


The Hospice GIP benefit is brief and not all facilities can offer this service.


The lack of a 2-day notice is acceptable if the patient is making the determination and was not denied coverage by the facility.


The Harmony Healthcare International (HHI) on-site and remote visit process is an intensive, detailed review of the medical record content to identify compliance risk areas, revenue and coding opportunities, systematic refinements with the overarching goal to improve medical record accuracy and minimize compliance concerns.


To learn more about our site visit process, click here.


Harmony Healthcare International (HHI) is available to assist with any questions or concerns that you may have. You can contact us by clicking here. Looking to train your staff? Join us in person at one of our upcoming Competency/Certification Courses. Click here to see the dates and locations. 

Click Here to View HHI's Education Calendar


Harmony Healthcare International (HHI) is hosting our 9th Annual Post-Acute and Long Term Care (PALTC) Interdisciplinary Symposium on Thursday, October 21st, 2021 and Friday, October 22nd, 2021 at the Encore Boston Harbor resort and casino.

Click below to register and for more information!

Click Here to Register for harmony21

harmony21 website

Topics: NOMNC, ABN

Kris Mastrangelo, OTR/L, LNHA, MBA


Kris Mastrangelo, OTR/L, LNHA, MBA

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