Skilled Nursing Facility Notice of Medicare Non-Coverage

Published 03/25/2025

Skilled Nursing Facilities (SNF) are required to provide a Notice of Medicare Non-Coverage (NOMNC) form to beneficiaries when their Medicare covered service(s) are ending.

The NOMNC must be delivered at least two calendar days before Medicare covered services end or the second to last day of service if care is not being provided daily.

Note: The two-day advance requirement is not a 48-hour requirement.

The provider must ensure that the beneficiary or representative signs and dates the NOMNC to demonstrate that the beneficiary or representative received the notice and understands that the termination decision can be disputed.

Providers must use the revised NOMNC beginning January 1, 2025, for Original Medicare and Medicare Advantage. Providers must also use the revised DENC beginning January 1, 2025, for Original Medicare, but there is an extended deadline to implement the DENC for Medicare Advantage.

This notice is found on CMS's website at FFS & MA NOMNC/DENC.

Form Instructions for the Notice of Medicare Non-Coverage (NOMNC) CMS-10123 (PDF) can be found on the above CMS website or by following this link.

This form informs beneficiaries how to request expedited determinations from Beneficiary and Family Centered Care Quality (BFCC-QIO). A Detailed Explanation of Non-Coverage (DENC) is given only if a beneficiary requests an expedited determination.

There are exceptions for this rule and are noted in the Form Instructions.

The NOMNC must remain two pages. The notice can be two sides of one page or one side of two separate pages but must not be condensed to one page.

Providers may include their business logo and contact information on the top of the NOMNC. Text may not be moved from page 1 to page 2 to accommodate large logos, address headers, etc.

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