MedicaidCoverageMedium impact
Syphilis Testing in Pregnancy
Nebraska Medicaid·NE · OB-GYN, Family Medicine, General Practice·Provider Bulletin
Effective date
Jul 31, 2025
We identified it
Jun 21, 2026
Summary
Nebraska Medicaid now covers syphilis testing at three specific points during pregnancy: first examination, third trimester examination, and at birth for all Medicaid-eligible mothers. This expands reimbursement coverage for serological syphilis tests during prenatal care.
Action Required
Immediately: Billing team should verify Nebraska Medicaid fee schedules at https://dhhs.ne.gov/Pages/Medicaid-Provider-Rates-and-Fee-Schedules.aspx to identify specific CPT codes and reimbursement rates for syphilis testing. Update billing procedures to ensure syphilis tests are billed to Nebraska Medicaid at first prenatal visit, third trimester, and delivery. Contact DHHS.MLTCMaternalHealth@nebraska.gov with questions.