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Attention Federally Qualified Health Center (FQHC) Providers: Clarification of Pharmacist Codes Billable for Encounters
Act
immediately
Effective date
Mar 20, 2026
Identified
Jun 21, 2026
Summary
Nevada Medicaid has clarified specific billing codes that pharmacists can use at FQHCs for various services including contraceptives, HIV prevention/treatment, substance abuse screening, and medication-assisted treatment. Some codes require system updates before they can be processed.
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What to do
immediately · 3 steps
01FQHC billing teams must update encounter forms and billing protocols to ensure pharmacist services use the specified CPT codes for medical encounters (oral contraceptives, HIV PrEP/PEP) and behavioral health encounters (SBIRT, MAT services).
02Note that codes 99205 and 99242-99245 for behavioral health encounters require a system update and claims will be reprocessed when completed.
03Contact medicalprograms@nvha.nv.gov for questions.
Codes mentioned
99202992039920499205992129921399214992159940199402994039940496372873898670182565H0049994089940999242992439924499245
Original notice
Attention Federally Qualified Health Center (FQHC) Providers: Clarification of Pharmacist Codes Billable for Encounters
medicaid.nv.gov · Always check the source before changing claims.
Related changes
See all Nevada Medicaid changes →Attention Provider Type 17 (Special Clinics) Specialty 181 (Federally Qualified Health Center): Shadow Billing UpdatesHighEffective Jan 1, 2026 · Billing & CodingAttention Provider Type 91 (Pharmacist): Opioid Use Disorder (OUD) Procedure CodesMediumEffective Aug 19, 2024 · Provider EnrollmentAttention Provider Type 60 (School Health Services): Service Limitations Added for Procedure Codes 99401, 99402, 99403, and 99404MediumEffective Aug 1, 2024 · Provider EnrollmentAttention Provider Types 14 (Behavioral Health Outpatient Treatment), 82 (Behavioral Health Rehabilitative Treatment), and 93 (Substance Use Treatment): Substance Use Treatment and Behavioral Health Procedure Codes Available for Billing (Updated)HighEffective Jul 1, 2024 · Billing & CodingBrowse every Nevada Medicaid change in the policy list
Related policy hubs
Nevada Medicaid policiesNV policy changesPharmacyFamily MedicineInfectious DiseaseCode 99202Code 99203Code 99204Code 99205Code 99212Code 99213Code 99214Code 99215Code 99401Code 99402Code 99403Code 99404Code 96372Code 87389Code 86701Code 82565Code H0049Code 99408Code 99409Code 99242Code 99243Code 99244Code 99245