Specialty × MAC Jurisdiction Intelligence
ESRDCMS & MAC AlertsNovitas Solutions · Jurisdictions JH, JL
Every CMS transmittal, Novitas Solutions LCD revision, Federal Register notice, and OIG alert affecting ESRD billing teams in Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, Texas, Delaware, District of Columbia, Maryland, New Jersey, Pennsylvania. Signal-scored and updated daily.
Active alerts
12
Critical / High
9
MAC jurisdiction
JH, JL
Highest-risk CPT
CPT 99214
Recent ESRD alerts under Novitas Solutions
9 of the 12 most recent ESRD reimbursement alerts are Critical/High-severity for Novitas Solutions (Jurisdictions JH, JL) billing teams. Each links to the source CMS/MAC document with the codes to review and the action to take.
- CMS Transmittal R246SOMA: Revisions to the State Operations Manual (SOM) Appendix H, End-Stage Renal Disease (ESRD)…Aug 18, 2026
- LCD L37475: Frequency of Hemodialysis — Wellpoint FederalNational Government Services · Jul 23, 2026
- CMS Transmittal R13822CP: Quarterly Update to the End Stage Renal Disease Prospective Payment System (ESRDPPS)Jun 10, 2026
- Federal Register Final Rule: Principles of Reasonable Cost Reimbursement; Payment for End-Stage Renal Disease Services; Prospectively Determined Payment Rates for Skilled Nursing Facilities; Payment for Acute Kidney Injury DialysisJun 5, 2026
- Federal Register Notice: Medicare and Medicaid Programs: Application From the Accreditation Commission for Health Care, Inc. for Continued Approval of Its End-Stage Renal Disease (ESRD) Accreditation ProgramJun 5, 2026
- Federal Register Final Rule: Medicare Program; End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, End-Stage Renal Disease Quality Incentive Program, and End-Stage Renal Disease Treatment Choices ModelJun 5, 2026
- Federal Register Proposed Rule: Medicare Program; End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, End-Stage Renal Disease Quality Incentive Program, and End-Stage Renal Disease Treatment Choices ModelJun 5, 2026
- Federal Register Final Rule: Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) ModelJun 5, 2026
- Federal Register Final Rule: Medicare Program; End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, Conditions for Coverage for End-Stage Renal Disease Facilities, End-Stage Renal Disease Quality Incentive Program, and End-Stage Renal Disease Treatment Choices ModelJun 5, 2026
- Federal Register Proposed Rule: Medicare Program; End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, Conditions for Coverage for End-Stage Renal Disease Facilities, End-Stage Renal Disease Quality Incentive Program, and End-Stage Renal Disease Treatment Choices ModelJun 5, 2026
- Federal Register Proposed Rule: Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) ModelJun 5, 2026
- Federal Register Final Rule: Medicare Program; End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, End-Stage Renal Disease Quality Incentive Program, and End-Stage Renal Disease Treatment Choices ModelJun 5, 2026
Signal intelligence — ESRD × Novitas Solutions
Highest-risk CPT code
CPT 99214
Office visit, established patient, moderate complexity
View full CPT alert profileNovitas Solutions jurisdiction
JH, JL
Covers Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, Texas, Delaware, District of Columbia, Maryland, New Jersey, Pennsylvania. Every esrd LCD revision, CMS transmittal, and Federal Register notice affecting these states is signal-scored and surfaced here daily.
View all 12 active alerts for ESRD under Novitas Solutions
Full alert text, action recommendations, effective date deadlines, MAC LCD links, and signal score rationale — updated daily.
About Novitas Solutions (Jurisdictions JH, JL)
Novitas Solutions is the Medicare Administrative Contractor responsible for processing Medicare Part A and Part B claims in Jurisdictions JH, JL, covering Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, Texas, Delaware, District of Columbia, Maryland, New Jersey, Pennsylvania.Novitas Solutions issues Local Coverage Determinations (LCDs) that define coverage criteria, ICD-10-CM diagnosis code requirements, and CPT billing guidelines for ESRD procedures within its jurisdiction. CLV Intelligence monitors Novitas Solutions's LCD publication feed, provider bulletin archives, and CMS contractor-specific transmittals daily.
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Frequently asked
- What are the recent CMS updates for ESRD under Novitas Solutions MAC?
- According to CLV Intelligence data, updated August 18, 2026, there are currently 12 active CMS and MAC reimbursement policy alerts for ESRD under Novitas Solutions (Jurisdictions JH, JL). Of these, 9 are classified Critical or High priority based on signal scoring of source authority, effective-date urgency, and document type. Alerts originate from Novitas Solutions Local Coverage Determinations (LCDs), CMS transmittals, Federal Register proposed and final rules, and OIG compliance publications. CLV Intelligence monitors all Novitas Solutions publications daily and assigns a signal score (0–100) to surface the changes most likely to affect coding accuracy and reimbursement.
- How many active audit alerts exist for ESRD CPT codes under Novitas Solutions?
- According to CLV Intelligence data, 12 active reimbursement and policy alerts currently affect ESRD CPT codes monitored under Novitas Solutions (Jurisdictions JH, JL). 9 of these alerts carry a Critical or High signal score, indicating elevated compliance risk or near-term effective dates requiring timely coding review. The highest-risk CPT code currently flagged in the ESRD alert set is CPT 99214 (Office visit, established patient, moderate complexity), which appears in Novitas Solutions LCD and CMS billing guidance revisions. CLV Intelligence cross-references each alert against the HCPCS and CPT code sets to surface procedure-level exposure for ESRD billing teams.
- Which MAC jurisdiction covers ESRD billing for practices in the Novitas Solutions region?
- Novitas Solutions administers Medicare Part A and Part B claims for practices in Jurisdictions JH, JL. For ESRD providers, Novitas Solutions issues Local Coverage Determinations (LCDs) that define coverage criteria, billing requirements, ICD-10-CM diagnosis code ranges, and CPT procedure code guidelines applicable to Medicare claims in its jurisdiction. According to CLV Intelligence data, Novitas Solutions monitors 12 open ESRD alerts as of August 18, 2026. Practices in the Novitas Solutions jurisdiction should monitor LCD revisions at Novitas Solutions's provider portal and through aggregated daily alerting services such as CLV Intelligence.
- Is CPT 99214 currently under CMS or MAC review for ESRD?
- According to CLV Intelligence data, CPT 99214 (Office visit, established patient, moderate complexity) is currently flagged as a high-signal procedure code within the ESRD alert set monitored under Novitas Solutions (Jurisdictions JH, JL). CMS and MAC contractors regularly review high-volume procedure codes for coverage criteria changes, NCCI edit revisions, medical necessity documentation requirements, and fee schedule adjustments. CLV Intelligence assigns CPT 99214 an elevated signal score based on the volume and recency of policy documents referencing this code. ESRD coding teams should review the latest Novitas Solutions LCD and CMS transmittals affecting CPT 99214 before claim submission to avoid denials or post-payment audits.