Number: 14354 
Revised Release Date: April 17, 2026
Effective Date: July 1, 2026 
Implementation Date: July 6, 2026
Transmittal Numbers: R13588CP & R13740CP

What’s Changed? CMS revised this article to add HCPCS code G0491 to the billing requirements for acute kidney injury hemodiafiltration claims. CMS also updated the CR release date, transmittal numbers, and transmittal links. Substantive content changes are in dark red (page 3).

CR 14354 explains:

• No need to submit the AX modifier on claims eligible for certain add-on payment adjustments under the ESRD PPS
• Must adhere to new billing instructions for hemodiafiltration and Acute Kidney Injury (AKI) claims

Make sure your billing staff knows about these updates, starting July 1, 2026, to billing instructions for ESRD Prospective Payment System (PPS) claims and to the Medicare Claims Processing Manual, Chapter 8, sections 20, 40, and 50. ESRD facilities

View the complete CMS Medicare Learning Network (MLN) Matters (MM)14354.