Advance Beneficiary Notice of Noncoverage (ABN)
Need help?
Contact Us About Claims
Claim Status/Patient Eligibility:
(866) 518-3285
24 hours a day, 7 days a week
Claim Corrections:
(866) 518-3253
7:00 am to 4:30 pm CT M-Th
DDE Navigation & Password Reset: (866) 518-3251
7:00 am to 4:30 pm CT M-F
DDE System Access: (866) 518-3295
7:00 am to 4:30 pm CT M-F
EDI: (866) 518-3285
7:00 am to 5:00 pm CT M-F
General Inquiries:
(866) 518-3285
7:00 am to 5:00 pm CT M-F
Claim Status/Patient Eligibility:
(866) 234-7331
24 hours a day, 7 days a week
Claim Corrections:
(866) 580-5980
8:00 am to 5:30 pm ET M-Th
DDE Navigation & Password Reset: (866) 580-5986
8:00 am to 5:30 pm ET M-F
DDE System Access: (866) 518-3295
8:00 am to 5:30 pm ET M-F
EDI: (866) 234-7331
8:00 am to 5:00 pm ET M-F
General Inquiries:
(866) 234-7331
8:00 am to 5:00 pm ET M-F
Claim Status/Patient Eligibility:
(866) 518-3285
24 hours a day, 7 days a week
Claim Corrections/Reopenings:
(866) 518-3285
7:00 am to 5:00 pm CT M-F
EDI: (866) 518-3285
7:00am to 5:00 pm CT M-F
General Inquiries:
(866) 518-3285
7:00 am to 5:00 pm CT M-F
Claim Status/Patient Eligibility:
(866) 234-7331
24 hours a day, 7 days a week
Claim Corrections/Reopenings:
(866) 234-7331
8:00 am to 5:00 pm ET M-F
EDI: (866) 234-7331
8:00 am to 5:00 pm ET M-F
General Inquiries:
(866) 234-7331
8:00 am to 5:00 pm ET M-F
Need help?
General questions about Medical Review
- (866) 518-3285
7:00 am to 5:00 pm CT M-F
- (866) 234-7331
8:00 am to 5:00 pm ET M-F
- (866) 518-3285
7:00 am to 5:00 pm CT M-F
- (866) 234-7331
8:00 am to 5:00 pm ET M-F
Need help?
Contact Us About Overpayments
Inquiries regarding refunds to Medicare - MSP Related
(866) 518-3285
7:00 am to 5:00 pm CT (8:00 am to 5:00 pm ET) M-Fri
Secondary.Payer.Inquiry@wpsic.com
Inquiries regarding overpayments NOT associated with MSP
(866) 518-3285
7:00 am to 5:00 pm CT (8:00 am to 5:00 pm ET) M-Fri
Reimbursement.Overpayment.
Inquiry@wpsic.com
Inquiries regarding refunds to Medicare - MSP Related
(866) 234-7331
7:00 am to 5:00 pm CT (8:00 am to 5:00 pm ET) M-Fri
Secondary.Payer.Inquiry@wpsic.com
Inquiries regarding overpayments NOT associated with MSP
(866) 234-7331
7:00 am to 5:00 pm CT (8:00 am to 5:00 pm ET) M-Fri
Reimbursement.Overpayment.
Inquiry@wpsic.com
Questions regarding overpayments associated with MSP related debt
(866) 518-3285
7:00 am to 5:00 pm CT (8:00 am to 5:00 pm ET) M-Fri
Secondary.Payer.Inquiry@wpsic.com
Questions regarding overpayments NOT associated with MSP related debt
(866) 518-3285
7:00 am to 5:00 pm CT (8:00 am to 6:00pm ET) M-Fri
Payment.Recovery.Inquiry@wpsic.com
Questions regarding overpayments associated with MSP related debt
(866) 234-7331
7:00 am to 5:00 pm CT (8:00 am to 5:00 pm ET) M-Fri
Secondary.Payer.Inquiry@wpsic.com
Questions regarding overpayments NOT associated with MSP related debt
(866) 234-7331
8:00 am to 5:00 pm ET (7:00 am to 4:00pm CT) M-Fri
Payment.Recovery.Inquiry@wpsic.com
Need help?
Contact us about Appeals
7:00 am to 5:00 pm CT M-F
8:00 am to 5:00 pm ET M-F
7:00 am to 5:00 pm CT M-F
8:00 am to 5:00 pm ET M-F
Need help?
Contact Us About Provider Enrollment
(866) 518-3285
7:00 AM - 5:00 PM CT, Monday - Friday
USPS Mailing Address
WPS GHA
Medicare Provider Enrollment
P.O. Box 8248
Madison, WI 53708-8248
Overnight Delivery
WPS GHA
Medicare Provider Enrollment
1717 W. Broadway
Madison, WI 53713-1834
(866) 234-7331
8:00 AM - 5:00 PM ET, Monday - Friday
USPS Mailing Address
WPS GHA
Medicare Provider Enrollment
P.O. Box 8248
Madison, WI 53708-8248
Overnight Delivery
WPS GHA
Medicare Provider Enrollment
1717 W. Broadway
Madison, WI 53713-1834
(866) 518-3285
7:00 AM - 5:00 PM CT, Monday - Friday
USPS Mailing Address
WPS GHA
Medicare Provider Enrollment
P.O. Box 8248
Madison, WI 53708-8248
Overnight Delivery
WPS GHA
Medicare Provider Enrollment
1717 W. Broadway
Madison, WI 53713-1834
(866) 234-7331
8:00 AM - 5:00 PM ET, Monday - Friday
USPS Mailing Address
WPS GHA
Medicare Provider Enrollment
P.O. Box 8248
Madison, WI 53708-8248
Overnight Delivery
WPS GHA
Medicare Provider Enrollment
1717 W. Broadway
Madison, WI 53713-1834
Need help?
Contact us about Policies
- (866) 518-3285 - General questions about Policies
7:00 am to 5:00 pm CT M-F
- (866) 234-7331 - General questions about Policies
8:00 am to 5:00 pm ET M-F
- (866) 518-3285 - General questions about Policies
7:00 am to 5:00 pm CT M-F
- (866) 234-7331 - General questions about Policies
8:00 am to 5:00 pm ET M-F
LCD Reconsideration Request: Policycomments@wpsic.com
Draft LCD Comments: Policycomments@wpsic.com
IDE Submissions: IDE.mailbox@wpsic.com
RSVP for Open Meeting and CAC: LCDCAC@wpsic.com
Questions about Payments and Incentive Programs
(866) 518-3285
7:00 am to 5:00 pm CT (8:00 am to 5:00 pm ET) M-F
Contact us about Form CMS-588 Electronic Funds Transfer (EFT)
(866) 518-3285
7:00 am to 5:00 pm CT (8:00 am to 5:00 pm ET) M-F
Financial.Reporting.Inquiry@wpsic.com
Do not submit PHI/PII through email
Questions about Payments and Incentive Programs
(866) 234-7331
7:00 am to 5:00 pm CT (8:00 am to 5:00 pm ET) M-F
Contact us about Form CMS-588 Electronic Funds Transfer (EFT)
(866) 234-7331
7:00 am to 5:00 pm CT (8:00 am to 5:00 pm ET) M-F
Financial.Reporting.Inquiry@wpsic.com
Do not submit PHI/PII through email
Questions about Payments, Fee Schedules, and Incentive Programs
(866) 518-3285
7:00 am to 5:00 pm CT (8:00 am to 5:00 pm ET) M-F
Contact us about Form CMS-588 Electronic Funds Transfer (EFT)
(866) 518-3285
7:00 am to 5:00 pm CT (8:00 am to 5:00 pm ET) M-F
Financial.Reporting.Inquiry@wpsic.com
Do not submit PHI/PII through email
Questions about Payments, Fee Schedules, and Incentive Programs
(866) 234-7331
7:00 am to 5:00 pm CT (8:00 am to 5:00 pm ET) M-F
Contact us about Form CMS-588 Electronic Funds Transfer (EFT)
(866) 234-7331
7:00 am to 5:00 pm CT (8:00 am to 5:00 pm ET) M-F
Financial.Reporting.Inquiry@wpsic.com
Do not submit PHI/PII through email
Need help?
Need help?
Mail audit materials:
WPS GHA
ATTN: Audit Supervisor
P.O. Box 8696
Madison, WI 53708-8696
When using a delivery service:
WPS GHA
ATTN: Audit Supervisor
1717 W. Broadway
Madison, WI 53713-1834
Mail audit materials:
WPS GHA
ATTN: Audit Supervisor
P.O. Box 14172
Madison, WI 53708-0172
When using a delivery service:
WPS GHA
ATTN: Audit Supervisor
1717 W. Broadway
Madison, WI 53713-1834
Need help?
Try these links first.
Questions about Self-Service?
(866) 518-3285
7:00 am to 5:00 pm CT M-F
Try these links first.
Questions about Self-Service?
(866) 518-3285
7:00 am to 5:00 pm CT M-F
Try these links first.
Questions about Self-Service?
(866) 234-7331
8:00 am to 5:00 pm ET M-F
Try these links first.
Questions about Self-Service?
(866) 234-7331
8:00 am to 5:00 pm ET M-F
Advance Beneficiary Notice of Noncoverage (ABN)
You currently have jurisdiction selected, however this page only applies to these jurisdiction(s): .
An Advance Beneficiary Notice of Noncoverage (ABN) is a written notice given to a Medicare patient. The ABN informs the patient that the provider believes Medicare will deny some or all the services or items. The provider believes the denial is due to medical necessity or the frequency of the service. The ABN transfers liability from the provider to the patient in certain circumstances.
ABN Purpose
ABN provides financial protection for both the provider and patient.
An ABN protects a patient by:
- Allowing informed decisions about receiving services or items they or another insurance may have to pay for.
- Allowing the patient to better participate in their own health care treatment decisions.
- Informing them of financial responsibility when Medicare is unlikely to pay for a particular service.
An ABN protects a provider by:
- Allowing them to collect payment from the patient if Medicare denies the service for:
- Not being medically necessary
- The frequency of the service
- Providing provisions for patient refusal to sign the ABN.
Services Medicare excludes from coverage do not need an ABN to change patient liability to provider liability. Providers may choose to provide the ABN. The optional notice allows the beneficiary to remain informed on a service Medicare never covers.
CMS Internet-Only Manual (IOM) 100-04 Medicare Claims Processing Manual, Chapter 30 – Financial Liability Protections , Section 50 explains the CMS ABN purpose further.
Providers Who Issue an ABN
The following providers issue the ABN:
- Facilities providing outpatient services covered under Medicare Part B
- Rural Health Clinics
- Independent laboratories
- Home health agencies
- Hospices
- Physicians
- Non-physician Practitioners
- Suppliers
The CMS-R 131 Form
CMS requires providers to use the CMS-R-131 form. You can download the form from the CMS FFS ABN web page.
Medicare considers a form valid when the following occurs:
- The provider completes their part before presenting the ABN.
- The person presenting explains the form and answers questions.
- The patient or their representative signs the form.
- The provider copies the form and gives the copy to the patient.
If a provider realizes the service is not medically necessary after starting the service, stop and prepare the ABN. Follow the remaining steps before proceeding with the service.
Completing the ABN
Providers must complete the form before presenting it to the patient. CMS provides detailed instructions for completing the ABN on their FFS ABN web page.
The provider completes the following fields:
- The top of the form:
- Notifies the patient with provider information, this includes:
- Individual providers
- Clinic names
- Facility names
- Patient name matching the Medicare system
- Identification number is optional and contains the provider’s internal filing number
- Notifies the patient with provider information, this includes:
- Center of Form:
- Blanks labeled in field D
- Chart
- D: description of the item or service
- E: reason for denial
- F: cost of the item or service
- Additional information, if necessary, in field H
After completing the form, Medicare does not allow changes to the information. The provider must present the patient a copy of the form.
In the notifiers section, you may include ancillary service providers. This would include providers the patient does have face-to-face contact with, e.g., labs.
Cost
The provider must determine the cost within 100 or 25 percent, whichever is greater, of the actual patient responsibility. CMS instructs providers that estimating high is generally acceptable.
Customizing the ABN
Notifiers can do some ABN customization. This includes pre-printing items in certain blanks to promote efficiency and to ensure clarity for patients. Notifiers may develop multiple versions of the ABN specialized to common treatment scenarios. Remove letter of the blanks (A-J) prior to issuance of an ABN.
If a patient has Medicare and Medicaid, the provider must alter option 1 in field G. Strikethrough the following:
- You may ask to be paid now, but I also…
- I understand that if Medicare doesn’t pay, I am responsible for payment, but I can appeal to Medicare by following the directions on the MSN.
Do not modify the ABN except as allowed by the CMS instructions . Notifiers must exercise caution before adding any changes beyond these guidelines. Changing the ABN too much could result in invalid notice and provider liability for noncovered charges.
Presenting the ABN
A provider or staff member presents the form. The person explains the content and answers questions. If they are not able to answer, refer the patient to Medicare, allowing time to make the call.
The person presenting may want to consider handwriting answers to questions in field H. This allows the patient to reference the answer later.
Patient’s Portions to Complete
After answering questions, the patient, or their representative:
- Chooses an option in field G.
- Signs on the blank section I and if necessary, add “rep” or “representative”
- Dates the ABN on blank section J.
If providing the ABN to inform the patient Medicare excludes coverage, Medicare does not require an ABN.
Unable or refuse to sign
Providers are not able to document the patient’s verbal consent. The patient or their representative must sign and date the form.
Patient’s representatives can sign the ABN if the patient refuses or is unable to sign. When a representative signs, the signature must be legible or have a printed name below it. The form must note "rep" or "representative."
Patients or their representatives cannot refuse to sign an ABN and expect their financial liability waived.
If a patient refuses to sign a properly issued ABN, providers should consider not furnishing the item or service. Providers must consider the consequences of refusing the service. These include:
- The patient’s health and safety
- Civil liability in case of harm
If refusing to furnish the item or service is not an option, choose guidelines based on the claim assignment.
Patient’s Copy
Providers must supply a copy of the ABN to the patient. The provider can retain the original or scan it and use that as the patient’s copy.
Billing with an ABN Modifier
Bill the claim as normal. Add a modifier to represent the ABN or lack of one. Choose from the following modifiers:
- GA: Valid and signed ABN on file for a service not medically necessary
- Medicare considers the claim for medical necessity.
- If Medicare finds a claim or portion of it not medically necessary, Medicare assigns this as patient liability.
- Offers patient’s appeal rights.
- GX: Valid and signed ABN on file for a service not included in Medicare’s benefits.
- Medicare does not review for medical necessity.
- Medicare assigns patient liability.
- Offers patient’s appeal rights.
- GZ: No ABN on file, but Medicare requires one to change patient liability.
- Medicare does not review for medical necessity.
- Medicare assigns provider liability.
- Offers patient’s appeal rights.
Use modifiers GZ with the specific procedure code when one is available. If there is no specific procedure code, use a "not otherwise classified code" (NOC) with the GZ modifier.
To learn more about excluded services and the use of modifier GX, view our Excluded Services and Providers web page.
Patient Refusal to Sign and Billing Assigned Claims
The provider can still bill the patient if a person witnesses the refusal. The provider or their representative must document the refusal. The medical record must contain the following items and be available upon request:
- Refusal date
- The person refusing to sign, i.e., the patient or their representative
- The name of person witnessing the refusal and their signature
- This is optional
- We recommend this for your protection during a legal challenge
- The services and date of service involved (as they appear on the ABN)
Bill the claim with modifier GA representing a valid ABN is on file.
Patient Refusal to Sign and Billing Non-assigned Claims
Providers choosing to provide services after a patient refuses to sign the ABN must write off the services. Medicare does not accept non-assigned claims with the modifier GA even when taking the above steps.
Repetitive Scheduled Services
It is not necessary to fill out a separate ABN each time a patient returns for the same treatment. The ABN may remain effective until the provider needs to change the information on it. This includes rehabilitation therapy, weekly foot care, or chiropractic manipulations. You can present the patient with one ABN identifying each service in a series of treatments. It must contain the individual date(s), a narrative description of the procedure, and the patient's signature. Bill a separate claim form if
- the ABN does not list services individually.
- services are not part of a series.
Electronic ABNs
CMS currently does not have a written policy on the electronic issuance of ABNs. Provides may choose to give an electronic ABN. These are the CMS recommendations offered to providers and suppliers using electronic ABNs:
- If issuing an electronic ABN, provide the option for requesting a paper ABN.
- You can print an ABN for issuance and the patient can sign it.
- Scan the signed ABN into the electronic health record for retention.
- Provide the original to the patient in paper format.
Experimental Items or Services
Medicare denies payments for experimental items or services as not reasonable and necessary. This denial is under the Social Security Act 1862 (a) (1). Providers must give an ABN for this service. Without an ABN, the provider is responsible for writing off the billed service(s).
Home Health Agencies
Home Health Agencies (HHA) must use the CMS Form CMS-R-131 in certain situations. The IOM Publication 100-04, Medicare Claims Processing Manual, Chapter 30 - Financial Liability Protections , Section 50.15.4 gives examples of when a HHA needs an ABN. This section also explains how to complete the ABN for the examples provided. The form is available to download on the CMS website, FFS ABN web page.
Outpatient Therapy Services
The therapy cap provides protection for Medicare patients. As a result, providers must give patients an ABN when services are over the Medicare Therapy Cap. CMS suggests using language such as:
"You have met your physical therapy goals, and physical therapy is no longer medically necessary. Medicare doesn't pay for physical therapy services that aren't medically reasonable and necessary."
CMS doesn't require an ABN if the therapy service is medically necessary. In such a case, the provider should continue to append the KX modifier on claims submitted.
The IOM Publication 100-04, Medicare Claims Processing Manual, Chapter 30 - Financial Liability Protections , Section 50.15.5 provides clarification on using the ABN for outpatient therapy services.
ABN and Prior Authorization
If we do not affirm your prior authorization, provide an ABN for outpatient services. The non-affirmation indicates we do not consider the service medically necessary.
Routine Notice Prohibition
CMS prohibits providers from issuing ABNs on a routine basis. Routine basis occurs when there is no reasonable basis to expect that Medicare may not cover the item or service. Providers must ensure a reasonable basis exists for noncoverage associated with the issuance of each ABN. In general, Medicare prohibits routinely given generic and "blanket" notices. This will not protect the provider from liability.
For more information see the Medicare Advance Written Notices of Non-coverage booklet.
ABN Resources
CMS Advance Beneficiary Notice of Non-coverage Tutorial
CMS Beneficiary Notices Initiative (BNI) web page
CMS Medicare Advance Written Notices of Non-coverage Booklet
CMS Internet-Only Manual 100-04 Medicare Claims Processing Manual, Chapter 30 – Financial Liability Protections , Section 50
global-tags: J8A,J5A,Advance Beneficiary Notice of Non-Coverage,J8B,J5B,Claims
Need help?
Contact Us About Claims
Claim Status/Patient Eligibility:
(866) 518-3285
24 hours a day, 7 days a week
Claim Corrections:
(866) 518-3253
7:00 am to 4:30 pm CT M-Th
DDE Navigation & Password Reset: (866) 518-3251
7:00 am to 4:30 pm CT M-F
DDE System Access: (866) 518-3295
7:00 am to 4:30 pm CT M-F
EDI: (866) 518-3285
7:00 am to 5:00 pm CT M-F
General Inquiries:
(866) 518-3285
7:00 am to 5:00 pm CT M-F
Claim Status/Patient Eligibility:
(866) 234-7331
24 hours a day, 7 days a week
Claim Corrections:
(866) 580-5980
8:00 am to 5:30 pm ET M-Th
DDE Navigation & Password Reset: (866) 580-5986
8:00 am to 5:30 pm ET M-F
DDE System Access: (866) 518-3295
8:00 am to 5:30 pm ET M-F
EDI: (866) 234-7331
8:00 am to 5:00 pm ET M-F
General Inquiries:
(866) 234-7331
8:00 am to 5:00 pm ET M-F
Claim Status/Patient Eligibility:
(866) 518-3285
24 hours a day, 7 days a week
Claim Corrections/Reopenings:
(866) 518-3285
7:00 am to 5:00 pm CT M-F
EDI: (866) 518-3285
7:00am to 5:00 pm CT M-F
General Inquiries:
(866) 518-3285
7:00 am to 5:00 pm CT M-F
Claim Status/Patient Eligibility:
(866) 234-7331
24 hours a day, 7 days a week
Claim Corrections/Reopenings:
(866) 234-7331
8:00 am to 5:00 pm ET M-F
EDI: (866) 234-7331
8:00 am to 5:00 pm ET M-F
General Inquiries:
(866) 234-7331
8:00 am to 5:00 pm ET M-F
.
View AMA License
LICENSE FOR USE OF PHYSICIANS' CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION (CPT)
End User Point and Click Agreement:
CPT codes, descriptions and other data only are copyright 2022 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).
You, your employees and agents are authorized to use CPT only as contained in the following authorized materials of Centers for Medicare and Medicaid Services (CMS) internally within your organization within the United States for the sole use by yourself, employees and agents. Use is limited to use in Medicare, Medicaid or other programs administered by CMS. You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.
Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60654. Applications are available at the AMA Web site, http://www.ama-assn.org/go/cpt.
Applicable FARS\DFARS Restrictions Apply to Government Use. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60654. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.
AMA Disclaimer of Warranties and Liabilities.
CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this agreement.
CMS Disclaimer
The scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT should be addressed to the AMA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.
Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by clicking above on the button labeled "Accept".
LICENSE FOR USE OF CURRENT DENTAL TERMINOLOGY (CDT™)
These materials contain Current Dental Terminology (CDTTM), Copyright © 2010 American Dental Association (ADA). All rights reserved. CDT is a trademark of the ADA.
THE LICENSE GRANTED HEREIN IS EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT. BY CLICKING ABOVE ON THE BUTTON LABELED "ACCEPT", YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THIS AGREEMENT.
IF YOU DO NOT AGREE WITH ALL TERMS AND CONDITIONS SET FORTH HEREIN, CLICK BELOW ON THE BUTTON LABELED "DO NOT ACCEPT" AND EXIT FROM THIS COMPUTER SCREEN.
IF YOU ARE ACTING ON BEHALF OF AN ORGANIZATION, YOU REPRESENT THAT YOU ARE AUTHORIZED TO ACT ON BEHALF OF SUCH ORGANIZATION AND THAT YOUR ACCEPTANCE OF THE TERMS OF THIS AGREEMENT CREATES A LEGALLY ENFORCEABLE OBLIGATION OF THE ORGANIZATION. AS USED HEREIN, "YOU" AND "YOUR" REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING.
- Subject to the terms and conditions contained in this Agreement, you, your employees and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials.
- Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Applications are available at the American Dental Association web site, http://www.ADA.org/.
- Applicable Federal Acquisition Regulation Clauses (FARS)\Department of restrictions apply to Government Use. Please click here to see all U.S. Government Rights Provisions.
- ADA DISCLAIMER OF WARRANTIES AND LIABILITIES. CDT IS PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND, EITHER EXPRESSED OR IMPLIED, INCLUDING BUT NOT LIMITED TO, THE IMPLIED WARRANTIES O F MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. NO FEE SCHEDULES, BASIC UNIT, RELATIVE VALUES OR RELATED LISTINGS ARE INCLUDED IN CDT. THE ADA DOES NOT DIRECTLY OR INDIRECTLY PRACTICE MEDICINE OR DISPENSE DENTAL SERVICES. THE SOLE RESPONSIBILITY FOR THE SOFTWARE, INCLUDING ANY CDT AND OTHER CONTENT CONTAINED THEREIN, IS WITH (INSERT NAME OF APPLICABLE ENTITY) OR THE CMS; AND NO ENDORSEMENT BY THE ADA IS INTENDED OR IMPLIED. THE ADA EXPRESSLY DISCLAIMS RESPONSIBILITY FOR ANY CONSEQUENCES OR LIABILITY ATTRIBUTABLE TO OR RELATED TO ANY USE, NON-USE, OR INTERPRETATION OF INFORMATION CONTAINED OR NOT CONTAINED IN THIS FILE/PRODUCT. This Agreement will terminate upon notice to you if you violate the terms of this Agreement. The ADA is a third party beneficiary to this Agreement.
- CMS DISCLAIMER. The scope of this license is determined by the ADA, the copyright holder. Any questions pertaining to the license or use of the CDT should be addressed to the ADA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CDT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. IN NO EVENT SHALL CMS BE LIABLE FOR DIRECT, INDIRECT, SPECIAL, INCIDENTAL, OR CONSEQUENTIAL DAMAGES ARISING OUT OF THE USE OF SUCH INFORMATION OR MATERIAL.