Remember when Method II billing process received more clarification on August 1, 2025?
Now, starting January 2, 2026, CMS will Return to Provider (RTP) any CAH professional service claims without a valid reassignment (CMS-855A) on file in PECOS.
The Critical Access Hospital (CAH) can bill for both facility and professional outpatient services only when its physicians have officially reassigned their billing rights to the CAH via CMS-855A.
RCM Teams – Heads Up!
CAH billers must stay alert to prevent claim denials under FISS reason codes 31006 and 31007, which indicate that a physician’s reassignment of benefits is missing in PECOS/Medicare.
At Cred2Bill, our core expertise lies in Credentialing, Enrollments, and Contracting, but we go a step further:
We’re intentional about collaborating closely with our clients’ Revenue Cycle Management (RCM) teams, whether they’re in-house or outsourced.
Because let’s face it:
We can credential providers flawlessly, with the right taxonomy, designation, and PECOS accuracy,
… but if the billing setup doesn’t align, reimbursement suffers.
And nowhere is that impact more visible than in CAHs, RHCs, IHS facilities, and independent practices, where every dollar of revenue realization matters.
At Cred2Bill, collaboration isn’t optional – it’s how we ensure our clients are compliant, credentialed, and reimbursed right.
