CMS To Reprocess Certain CAH Method II Claims

The Centers for Medicare & Medicaid Services released a notification for critical access hospitals that utilize Method II billing for professional services. “Certain CAH claims were incorrectly returned with Fiscal Intermediary Shared System (FISS) reason codes 31006 and 31007 indicating that providers don’t have a reassignment on file in PECOS. To address this issue, the Medicare Administrative Contractors (MACs) stopped returning these claims with dates of service in 2025 and 2026. They will reprocess claims that were incorrectly returned since Jan. 1, 2026. Payments should be issued in approximately two weeks. CAHs do not need to take any action.”