CMS has directed Medicare Administrative Contractors (MACs) to temporarily stop using two claim denial reason codes-31006 and 31007-effective immediately. This pause follows a March 20, 2026, CMS notification and will remain in place until CMS determines that providers have had enough time to meet the new claims processing requirements.

These reason codes were created as part of Change Request (CR) 13900, which added new checks to confirm that physicians have properly reassigned their Medicare benefits to Critical Access Hospitals (CAHs). The goal of the change was to ensure that reassignment information is on file when CAHs submit claims for professional services.

However, CMS has learned that many providers did not have reassignment records on file in the Provider Enrollment, Chain, and Ownership System (PECOS) for services provided between July 1, 2025, and December 31, 2025. This appears to have happened because some CAHs understood the new requirements to apply only to services starting January 1, 2026, not earlier dates.

Due to this misunderstanding, CMS has decided to temporarily turn off reason codes 31006 and 31007 for all dates of service. This pause will give providers more time to submit claims correctly and allow MACs to offer additional education and guidance to CAHs.

CMS is planning on activating the reason codes again and CAHs need to make sure that they have completed all their reassignments in PECOS prior to that activation or they will find their claims returned to providers.