Nebraska Medicaid: Knee injection coverage and attestation for single-dose drugs
AI Summary
Effective January 1, 2026, Nebraska Medicaid will discontinue coverage for all hyaluronan knee injections for osteoarthritis and require providers to attest no-waste drug use with modifier JZ for single-dose medications. Ten specific HCPCS codes for knee injections will no longer be reimbursed.
Action Required
By January 1, 2026: Billing team must update system to deny/flag HCPCS codes J7320, J7321, J7322, J7324, J7325, J7326, J7327, J7329, J7331, J7332 for Nebraska Medicaid patients as non-covered. Add modifier JZ to all single-dose drug claims for Nebraska Medicaid. Providers must document any drug wastage in medical records. Update encounter forms and billing software rules. Claims without proper attestation or for discontinued codes will be denied.
Affected Billing Codes
Plan Types
Medicaid
States
NE
Specialties
ortho, rheumatology, pain-management, sports-medicine