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Attention Provider Type 60 (School Health Services): Ordering, Prescribing and Referring Requirements Updated
Effective date
Mar 9, 2026
Identified
Jun 21, 2026
Summary
Nevada Medicaid updated ordering, prescribing and referring (OPR) provider requirements for School Health Services providers. Effective March 9, 2026, specific procedure codes will require the ordering provider's NPI on claims or they will be denied, while some codes no longer require OPR provider NPIs as of July 1, 2024.
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What to do
Action · 3 steps
01Before March 9, 2026: Billing team must update Nevada Medicaid claims for Provider Type 60 (School Health Services) to include ordering provider NPI for codes 80305, 80306, 80307, 86328, 87426, 87428, 87636, 87637, 87811, 87635, 92507, 92508, 92605-92609, 97010, 97161-97167, 97763, A4287, B4148, E0602, E0603, 99366/99368 with modifier TD, and H0034 with modifier TD.
02Ensure the NPI belongs to an individual provider who is authorized and active in Nevada Medicaid.
03Claims without required NPIs will be denied with error codes 1022 or 1027.
Codes mentioned
80305803068030786328874268742887636876378781187635925079250892605926069260792608926099701097161971629716397165971669716797763A4287B4148E0602E06039936699368H003492524926019260292603926049262692627A5200G0515K0552Q3014
Original notice
Attention Provider Type 60 (School Health Services): Ordering, Prescribing and Referring Requirements Updated
medicaid.nv.gov · Always check the source before changing claims.
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Related policy hubs
Nevada Medicaid policiesNV policy changesAudiologyPhysical TherapySpeech TherapyCode 80305Code 80306Code 80307Code 86328Code 87426Code 87428Code 87636Code 87637Code 87811Code 87635Code 92507Code 92508Code 92605Code 92606Code 92607Code 92608Code 92609Code 97010Code 97161Code 97162Code 97163Code 97165Code 97166Code 97167Code 97763Code A4287Code B4148Code E0602Code E0603Code 99366Code 99368Code H0034Code 92524Code 92601Code 92602Code 92603Code 92604Code 92626Code 92627Code A5200Code G0515Code K0552Code Q3014