Article Detail - JE Part A

The critical access hospital (CAH) bills for facility and professional outpatient services only when physicians or practitioners reassign their billing rights to the CAH.

Learn how CAHs can prevent Fiscal Intermediary Shared System (FISS) reason codes 31006 and 31007 (indicating that providers don’t have a reassignment on file in the Provider Enrollment, Chain, and Ownership System (PECOS)) claim denials:

• CAHs must submit the reassignment application through PECOS or the paper Form CMS-855I
• Starting in January 2026, we’ll deny CAH claims for professional services if are assignment isn’t in PECOS

More Information:

• Information for Critical Access Hospitals (PDF) booklet revised to add reassignment information
• Editing for Duplicate Processing for Practitioner Professional Services and CAH Professional Services(PDF) Medicare Administrative Contractor instruction
• Medicare Part B Overpaid and Beneficiaries Incurred Cost-Share Overcharges of Over $1Million for the Same Professional Services Office of the Inspector General report

Source: CMS MLN Connects dated August 21, 2025