CMS Revises Nebulizer Policy and ABN Form

Published in Government Relations on February 11, 2026

CMS has issued an update regarding revisions to the CMS Nebulizer Policy Article and guidance on the Advanced Beneficiary Notice of Noncoverage (ABN) Form. 

For dates of service on or after Feb. 1, 2026, suppliers must include the KX, GA, or GZ modifier to claims for the following nebulizer items: 

  • Nebulizers 
  • Nebulizer-related drugs 
  • Nebulizer-related supplies 

CMS has indicated that they will reject claims submitted without one of these modifiers. For more information, see the Nebulizer Local Coverage Determination (LCD) or Nebulizer Policy Article

Advance Beneficiary Notice of Noncoverage (ABN) Expiration Update 

CMS has advised providers to continue to use the Advance Beneficiary Notice of Noncoverage (ABN) Form CMS-R-131 despite it expiring on Jan. 31, 2026. 

CMS advises monitoring the CMS Beneficiary Notices Initiative website for updates. CMS will announce it on this site once the Office of Management and Budget (OMB) approves the updated form. Providers will have 60 calendar days to start using the updated version from the date of the CMS announcement.  

Click here for the CMS Beneficiary Notices Initiative (BNI) and CGS News webpages. 

From Our Experts

Thank You for Attending ‘What's Ahead for the DME Industry'. Recording Now Available. thumbnail Thank You for Attending ‘What's Ahead for the DME Industry'. Recording Now Available. Thank you for joining VGM Group's Ike Isaacson and AAHomecare's Jay Witter legislative update webinar. With significant movement at the federal level, we appreciated the opportunity to share the latest developments, emerging challenges, and what suppliers should be watching right now. WEBINAR: Current Legislative Update – What's Ahead for the DME Industry thumbnail WEBINAR: Current Legislative Update – What's Ahead for the DME Industry Join VGM Group's Ike Isaacson and AAHomecare's Jay Witter for a timely legislative update on the issues shaping the DME industry. With significant movement at the federal level, this session will break down the latest developments, emerging challenges, and what suppliers should be watching right now. Meet the Candidates: Rob Sand, Iowa State Auditor and Gubernatorial Candidate, Visits VGM thumbnail Meet the Candidates: Rob Sand, Iowa State Auditor and Gubernatorial Candidate, Visits VGM On Thursday, April 16, VGM Group welcomed Iowa State Auditor and gubernatorial candidate Rob Sand to its headquarters as part of VGM's Meet the Candidates series. VGM Government Relations Participates in the Iowa Center for Employee Ownership's (IA-CEO) Day at the Capitol thumbnail VGM Government Relations Participates in the Iowa Center for Employee Ownership's (IA-CEO) Day at the Capitol Alongside Amber Brauner, VGM Group's Compensation and Retirement Director, Adam Miller, Vice President of VGM Government Relations, joined numerous employee owners and advocates from employee-owned businesses (ESOPs) across Iowa for a panel discussion with several state legislators and Iowa's Lieutenant Governor. CMS Updates FAQ On Competitive Bidding Program thumbnail CMS Updates FAQ On Competitive Bidding Program On April 2, the Centers for Medicare and Medicaid Services (CMS) issued a new FAQ, inclusive of 24 new questions and answers, on the next round of DMEPOS Competitive Bidding Program (CBP) via CBIC, the official information source for bidders and focal point for bidder education. VGM Group Submits Comments on CMS-6098-NC Request for Information (RFI) Related to Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH). thumbnail VGM Group Submits Comments on CMS-6098-NC Request for Information (RFI) Related to Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH). The comments reflect VGM Group's support of CMS' goal of strengthening program integrity and shares CMS' commitment to protecting Medicare beneficiaries and taxpayer dollars from fraud, waste, and abuse. DME suppliers already operate in a highly regulated environment and have a direct interest in ensuring that anti-fraud initiatives are precisely targeted, data driven, and operationally feasible, so that legitimate suppliers can continue to serve beneficiaries without unnecessary disruption. Call To Action - Access to Power Seat Elevation on Standard PWCs Threatened thumbnail Call To Action - Access to Power Seat Elevation on Standard PWCs Threatened As reported by NCART: Do you use, recommend or provide power seat elevation for individuals with any of the diagnoses below? If so, and you answer YES to any of the questions below, it is important for Medicare to hear your story in writing by midnight on Saturday, April 4 at PMDRecon@noridian.com. Florida Becomes First State To Follow Medicare; Issues A Six-month Moratorium On DMEPOS Suppliers Enrolling In Medicaid thumbnail Florida Becomes First State To Follow Medicare; Issues A Six-month Moratorium On DMEPOS Suppliers Enrolling In Medicaid As reported by The van Halem Group: On Thursday, March 26, 2026, the Agency for Health Care Administration (AHCA) issued a temporary moratorium on enrollment of new Medicaid providers for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS).