Specialty × MAC Jurisdiction Intelligence
Skilled Nursing FacilityCMS & MAC AlertsWPS Government Health Administrators · Jurisdictions J5, J8
Every CMS transmittal, WPS Government Health Administrators LCD revision, Federal Register notice, and OIG alert affecting Skilled Nursing Facility billing teams in Indiana, Iowa, Kansas, Michigan, Missouri, Nebraska. Signal-scored and updated daily.
Active alerts
12
Critical / High
7
MAC jurisdiction
J5, J8
Highest-risk CPT
CPT 99213
Recent Skilled Nursing Facility alerts under WPS Government Health Administrators
7 of the 12 most recent Skilled Nursing Facility 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.
- Federal Register Notice: Privacy Act of 1974; System of RecordsAug 20, 2026
- CMS Transmittal R13850CP: Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Web Pricer…Aug 8, 2026
- Federal Register Final Rule: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2027Jul 31, 2026
- CMS Transmittal R503PR1: Section 2231, Regional Medicare Swing-Bed-Rates, updates Table 38 to correct the Medicare…Jul 2, 2026
- CMS Transmittal R530PR1: Section 2231, Regional Medicare Swing-Bed-Rates, updates Table 38 to correct the Medicare…Jul 1, 2026
- Federal Register Final Rule: Medicare and Medicaid Programs; Repeal of Minimum Staffing Standards for Long-Term Care FacilitiesJun 5, 2026
- Federal Register Final Rule: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2025; CorrectionJun 5, 2026
- Federal Register Final Rule: Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting; CorrectionJun 5, 2026
- Federal Register Final Rule: Medicare and Medicaid Programs; Policy and Regulatory Changes to the Omnibus COVID-19 Health Care Staff Vaccination Requirements; Additional Policy and Regulatory Changes to the Requirements for Long-Term Care (LTC) Facilities and Intermediate Care Facilities for Individuals With Intellectual Disabilities (ICFs-IID) To Provide COVID-19 Vaccine Education and Offer Vaccinations to Residents, Clients, and Staff; Policy and Regulatory Changes to the Long Term Care FaciliJun 5, 2026
- Federal Register Proposed Rule: Medicare and Medicaid Programs; Disclosures of Ownership and Additional Disclosable Parties Information for Skilled Nursing Facilities and Nursing FacilitiesJun 5, 2026
- Federal Register Proposed Rule: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2027Jun 5, 2026
- Federal Register Final Rule: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026Jun 5, 2026
Signal intelligence — Skilled Nursing Facility × 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 skilled nursing facility LCD revision, CMS transmittal, and Federal Register notice affecting these states is signal-scored and surfaced here daily.
View all 12 active alerts for Skilled Nursing Facility 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 Skilled Nursing Facility procedures within its jurisdiction. CLV Intelligence monitors WPS Government Health Administrators'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 Skilled Nursing Facility under WPS Government Health Administrators MAC?
- According to CLV Intelligence data, updated August 20, 2026, there are currently 12 active CMS and MAC reimbursement policy alerts for Skilled Nursing Facility under WPS Government Health Administrators (Jurisdictions J5, J8). Of these, 7 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 Skilled Nursing Facility CPT codes under WPS Government Health Administrators?
- According to CLV Intelligence data, 12 active reimbursement and policy alerts currently affect Skilled Nursing Facility CPT codes monitored under WPS Government Health Administrators (Jurisdictions J5, J8). 7 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 Skilled Nursing Facility 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 Skilled Nursing Facility billing teams.
- Which MAC jurisdiction covers Skilled Nursing Facility 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 Skilled Nursing Facility 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 Skilled Nursing Facility alerts as of August 20, 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 Skilled Nursing Facility?
- According to CLV Intelligence data, CPT 99213 (Office visit, established patient, low complexity) is currently flagged as a high-signal procedure code within the Skilled Nursing Facility 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. Skilled Nursing Facility 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.