Effective Date for Use of Form-CMS 10280 (HHCCN)

On June 2016, the Home Health Change of Care Notice (HHCCN), Form CMS-10280 was revised and approved by the Office of Management and Budget.  The revised HHCCN form that Home health agencies use to notify Original Medicare beneficiaries receiving home health care benefits of plan of care changes can be located at https://www.cms.gov/Medicare/Medicare-General-Information/BNI/HHCCN.html.  The effective date for use of the revised HHCCN form is 90 days from this announcement.

If you have any additional questions or comments, please send them to the ABN Resource Mailbox at RevisedABN_ODF@cms.hhs.gov.