Notice of Medicare Non-Coverage (NOMNC)

Plain-language definition

A Notice of Medicare Non-Coverage, commonly called a NOMNC, is the standardized notice used when a skilled nursing facility, home health agency, hospice, or comprehensive outpatient rehabilitation facility decides that the beneficiary’s Medicare-covered services will end.

What the notice contains

The notice states the proposed coverage end date, when possible financial responsibility begins, how to contact the BFCC-QIO, how to request an expedited determination, and the right to submit evidence supporting continued services.

When it is delivered

Federal rules generally require the provider to deliver the notice no later than two days before the proposed end of services. Different timing rules apply for very short service periods and certain non-residential visit schedules.

How it differs from a DENC

The NOMNC starts the notice and appeal process. A Detailed Explanation of Non-Coverage (DENC), Form CMS-10124, is provided only after the beneficiary requests a fast appeal. The DENC gives the specific coverage rationale and facts used to end services.

How it differs from other Medicare notices

The Important Message from Medicare concerns discharge from an inpatient hospital.
An Advance Beneficiary Notice of Non-coverage generally warns that Medicare may not pay for a particular item or service and may transfer financial responsibility.
A Medicare Summary Notice reports processed Original Medicare claims; it is not a termination notice.
A NOMNC covers a complete termination of the covered course of provider services, not merely a reduction or the end of one service while other covered services from that provider continue.

Practical example

A home health agency plans to end all covered visits on Friday and gives the beneficiary a NOMNC. The notice identifies Friday as the coverage end date and tells the beneficiary to contact the listed BFCC-QIO by noon on Thursday to request fast review.