US · guidance
CMS Pub. 100-04, ch. 32, § 150.9
Advance Beneficiary Notice and HINN Information
Physicians must be advised that the physician is liable for charges if the surgery is performed in an
unapproved facility, unless the beneficiary was informed that he or she would be financially responsible prior
to performance for the procedure. The provider must have the beneficiary sign an advance beneficiary notice
(ABN) if the bariatric surgery is performed in an unapproved facility. Note that the ABN is the appropriate
notice for Part B services.
The HINN model language should be adapted to this situation in the sections addressing: description of the
care at issue if the surgery is performed on an inpatient basis, in an unapproved facility, to avoid being liable,
the provider must issue a HINN. Other content requirements of HINN still apply. Use the HINN letter most
appropriate to the overall situation.
History
(Rev. 1233, Issued: 04-27-07, Effective: 02-21-06, Implementation: 05-29-07)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
ab497c0b2de96cc2a85e435afd4e18d4cc967ea4285e6002e0d32886b091d5ff
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