Specialty × MAC Jurisdiction Intelligence
OncologyCMS & MAC AlertsNovitas Solutions · Jurisdictions JH, JL
Every CMS transmittal, Novitas Solutions LCD revision, Federal Register notice, and OIG alert affecting Oncology 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
10
MAC jurisdiction
JH, JL
Highest-risk CPT
CPT 96413
Recent Oncology alerts under Novitas Solutions
10 of the 12 most recent Oncology 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.
- FDA Approval: RASONQUE (DARAXONRASIB) — Type 1 - New Molecular EntitySep 3, 2026
- FDA Approval: VOBRIG (LEUPROLIDE ACETATE) — Type 5 - New Formulation or New ManufacturerSep 3, 2026
- FDA Approval: LIBTAYO (CEMIPLIMAB-RWLC) — Type 1 - New Molecular EntitySep 3, 2026
- FDA Approval: BAVENCIO (AVELUMAB) — Type 1 - New Molecular EntitySep 3, 2026
- FDA Approval: UNLOXCYT (COSIBELIMAB) — Type 1 - New Molecular EntitySep 3, 2026
- FDA Approval: IMJUDO (TREMELIMUMAB) — Type 1 - New Molecular EntitySep 3, 2026
- FDA Approval: PENPULIMAB KCQX (PENPULIMAB) — Type 1 - New Molecular EntitySep 3, 2026
- FDA Approval: LOQTORZI (TORIPALIMAB-TPZI) — Type 1 - New Molecular EntitySep 3, 2026
- FDA Approval: TEVIMBRA (TISLELIZUMAB-JSGR) — Type 1 - New Molecular EntityAug 28, 2026
- FDA Approval: ZIIHERA (ZANIDATAMAB-HRII) — Type 1 - New Molecular EntityAug 28, 2026
- Proposed LCD DL40427: MolDX: Next-Generation Sequencing for Hematologic Malignancies and Suspected Hematologic Malignancies — NoridianNoridian · Aug 27, 2026
- Proposed LCD DL40435: MolDX: Transcriptional Biomarkers for Therapeutic Decision-Making in Renal Carcinoma — NoridianNoridian · Aug 27, 2026
Signal intelligence — Oncology × Novitas Solutions
Highest-risk CPT code
CPT 96413
Chemotherapy administration, intravenous push
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 oncology LCD revision, CMS transmittal, and Federal Register notice affecting these states is signal-scored and surfaced here daily.
View all 12 active alerts for Oncology 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 Oncology 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 Oncology under Novitas Solutions MAC?
- According to CLV Intelligence data, updated September 3, 2026, there are currently 12 active CMS and MAC reimbursement policy alerts for Oncology under Novitas Solutions (Jurisdictions JH, JL). Of these, 10 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 Oncology CPT codes under Novitas Solutions?
- According to CLV Intelligence data, 12 active reimbursement and policy alerts currently affect Oncology CPT codes monitored under Novitas Solutions (Jurisdictions JH, JL). 10 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 Oncology alert set is CPT 96413 (Chemotherapy administration, intravenous push), 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 Oncology billing teams.
- Which MAC jurisdiction covers Oncology 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 Oncology 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 Oncology alerts as of September 3, 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 96413 currently under CMS or MAC review for Oncology?
- According to CLV Intelligence data, CPT 96413 (Chemotherapy administration, intravenous push) is currently flagged as a high-signal procedure code within the Oncology 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 96413 an elevated signal score based on the volume and recency of policy documents referencing this code. Oncology coding teams should review the latest Novitas Solutions LCD and CMS transmittals affecting CPT 96413 before claim submission to avoid denials or post-payment audits.