Article Detail - JF Part A
Information for Critical Access Hospitals
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:
- CAHsmust submit the reassignment application through PECOS or the paper FormCMS-855I
- Startingin January 2026, we’ll deny CAH claims for professional services if areassignment isn’t in PECOS
More Information:
- Informationfor Critical Access Hospitals(PDF) booklet revised to addreassignment information
- Editing forDuplicate Processing for Practitioner Professional Services and CAHProfessional Services(PDF) Medicare AdministrativeContractor instruction
- Medicare PartB Overpaid and Beneficiaries Incurred Cost-Share Overcharges of Over $1Million for the Same Professional Services Office of theInspector General report
Source: CMS MLN Connects dated August 21, 2025
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