Specialty × MAC Jurisdiction Intelligence
Home HealthCMS & MAC AlertsWPS Government Health Administrators · Jurisdictions J5, J8
Every CMS transmittal, WPS Government Health Administrators LCD revision, Federal Register notice, and OIG alert affecting Home Health billing teams in Indiana, Iowa, Kansas, Michigan, Missouri, Nebraska. Signal-scored and updated daily.
Active alerts
12
Critical / High
9
MAC jurisdiction
J5, J8
Highest-risk CPT
CPT 99213
Recent Home Health alerts under WPS Government Health Administrators
9 of the 12 most recent Home Health reimbursement alerts are Critical/High-severity for WPS Government Health Administrators (Jurisdictions J5, J8) billing teams. Each links to the source CMS/MAC document with the codes to review and the action to take.
- CMS Transmittal R245SOMA: Revised Appendix B, Interpretive Guidelines for Home Health Agencies: New Acceptance-to-Service…Aug 6, 2026
- CMS Transmittal R13794CP: Quarterly Update of Healthcare Common Procedure Coding System (HCPCS) Codes Used for Home Health…Jul 10, 2026
- CMS Transmittal R13793CP: Quarterly Update to Home Health (HH) GrouperJul 10, 2026
- Federal Register Proposed Rule: Medicare Program; Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin (IVIG) Items and Services Rate Update; and Other Medicare PoliciesJun 5, 2026
- Federal Register Proposed Rule: Medicare Program; Calendar Year (CY) 2024 Home Health (HH) Prospective Payment System Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin Items and Services; Hospice Informal Dispute Resolution and Special Focus Program Requirements, Certain Requirements for Durable Medical Equipment Prosthetics and Orthotics Supplies; and Provider and Supplier Enrollment RequirementsJun 5, 2026
- Federal Register Final Rule: Medicare and Medicaid Programs; Calendar Year 2026 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the HH Value-Based Purchasing Expanded Model; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Updates; DMEPOS Accreditation Requirements; Provider Enrollment; and Other Medicare and Medicaid PoliciesJun 5, 2026
- Federal Register Notice: Privacy Act of 1974; System of RecordsJun 5, 2026
- Federal Register Proposed Rule: Medicare and Medicaid Programs; Calendar Year 2026 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the HH Value-Based Purchasing Expanded Model; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Updates; DMEPOS Accreditation Requirements; Provider Enrollment; and Other Medicare and Medicaid PoliciesJun 5, 2026
- Federal Register Final Rule: Medicare Program; Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin (IVIG) Items and Services Rate Update; and Other Medicare PoliciesJun 5, 2026
- Federal Register Final Rule: Medicare Program; Calendar Year (CY) 2024 Home Health (HH) Prospective Payment System Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin Items and Services; Hospice Informal Dispute Resolution and Special Focus Program Requirements, Certain Requirements for Durable Medical Equipment Prosthetics and Orthotics Supplies; and Provider and Supplier Enrollment RequirementsJun 5, 2026
- LCD L34562: Home Health Skilled Nursing Care-Teaching and Training: Alzheimer's Disease and Behavioral Disturbances — Palmetto GBAPalmetto GBA · Jun 5, 2026
- LCD L33942: Physical Therapy - Home Health — CGSCGS Administrators · Jun 5, 2026
Signal intelligence — Home Health × WPS Government Health Administrators
Highest-risk CPT code
CPT 99213
Office visit, established patient, low complexity
View full CPT alert profileWPS Government Health Administrators jurisdiction
J5, J8
Covers Indiana, Iowa, Kansas, Michigan, Missouri, Nebraska. Every home health LCD revision, CMS transmittal, and Federal Register notice affecting these states is signal-scored and surfaced here daily.
View all 12 active alerts for Home Health under WPS Government Health Administrators
Full alert text, action recommendations, effective date deadlines, MAC LCD links, and signal score rationale — updated daily.
About WPS Government Health Administrators (Jurisdictions J5, J8)
WPS Government Health Administrators is the Medicare Administrative Contractor responsible for processing Medicare Part A and Part B claims in Jurisdictions J5, J8, covering Indiana, Iowa, Kansas, Michigan, Missouri, Nebraska.WPS Government Health Administrators issues Local Coverage Determinations (LCDs) that define coverage criteria, ICD-10-CM diagnosis code requirements, and CPT billing guidelines for Home Health procedures within its jurisdiction. CLV Intelligence monitors WPS Government Health Administrators's LCD publication feed, provider bulletin archives, and CMS contractor-specific transmittals daily.
Home Health alerts in other MAC jurisdictions
Get weekly Home Health alerts for WPS Government Health Administrators — free
No credit card required. Unsubscribe any time.
Frequently asked
- What are the recent CMS updates for Home Health under WPS Government Health Administrators MAC?
- According to CLV Intelligence data, updated August 6, 2026, there are currently 12 active CMS and MAC reimbursement policy alerts for Home Health under WPS Government Health Administrators (Jurisdictions J5, J8). 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 WPS Government Health Administrators Local Coverage Determinations (LCDs), CMS transmittals, Federal Register proposed and final rules, and OIG compliance publications. CLV Intelligence monitors all WPS Government Health Administrators 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 Home Health CPT codes under WPS Government Health Administrators?
- According to CLV Intelligence data, 12 active reimbursement and policy alerts currently affect Home Health CPT codes monitored under WPS Government Health Administrators (Jurisdictions J5, J8). 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 Home Health alert set is CPT 99213 (Office visit, established patient, low complexity), which appears in WPS Government Health Administrators 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 Home Health billing teams.
- Which MAC jurisdiction covers Home Health billing for practices in the WPS Government Health Administrators region?
- WPS Government Health Administrators administers Medicare Part A and Part B claims for practices in Jurisdictions J5, J8. For Home Health providers, WPS Government Health Administrators 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, WPS Government Health Administrators monitors 12 open Home Health alerts as of August 6, 2026. Practices in the WPS Government Health Administrators jurisdiction should monitor LCD revisions at WPS Government Health Administrators's provider portal and through aggregated daily alerting services such as CLV Intelligence.
- Is CPT 99213 currently under CMS or MAC review for Home Health?
- According to CLV Intelligence data, CPT 99213 (Office visit, established patient, low complexity) is currently flagged as a high-signal procedure code within the Home Health alert set monitored under WPS Government Health Administrators (Jurisdictions J5, J8). 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 99213 an elevated signal score based on the volume and recency of policy documents referencing this code. Home Health coding teams should review the latest WPS Government Health Administrators LCD and CMS transmittals affecting CPT 99213 before claim submission to avoid denials or post-payment audits.