MedicaidBilling CodesMedium impact
Attention Federally Qualified Health Center (FQHC) Providers: Clarification of Pharmacist Codes Billable for Encounters
Nevada Medicaid·NV · Pharmacy, Family Medicine, Infectious Disease·Provider Announcement
Effective date
Mar 20, 2026
We identified it
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.
Action Required
Immediately: FQHC 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). Note that codes 99205 and 99242-99245 for behavioral health encounters require a system update and claims will be reprocessed when completed. Contact medicalprograms@nvha.nv.gov for questions.