MedicaidPrior AuthMedium impact
Attention Provider Type 33 (Durable Medical Equipment, Prosthetics, Orthotics and Supplies): Authorization Criteria Updated to Remove Incorrect Requirements
Nevada Medicaid·NV · Urology, Internal Medicine, Family Medicine +1 more·Prior Authorization
Effective date
Mar 16, 2026
We identified it
Jun 21, 2026
Summary
Nevada Medicaid corrected an error in their Provider Web Portal that incorrectly stated prior authorization was required for catheter codes A4351, A4352, and A4353 when exceeding 200 units per month. The portal now correctly shows that PA cannot be used to exceed this limit - claims over 200 units will simply be denied.
Action Required
Immediately: Billing team should verify that billing system and staff understand that prior authorization CANNOT be obtained to exceed the 200 unit per rolling month limit for catheter codes A4351, A4352, and A4353 in Nevada Medicaid. Claims exceeding 200 units will deny with error code 5731. Update any internal documentation that may have referenced the incorrect PA requirement.