MedicaidAdministrativeMedium impact
Attention Provider Type 17 (Special Clinics) Specialty 181 (Federally Qualified Health Clinics): Billing Guide Updated
Nevada Medicaid·NV · Family Medicine, General Practice, Internal Medicine·Billing & Coding
Effective date
Mar 6, 2026
We identified it
Jun 21, 2026
Summary
Nevada Medicaid updated billing guidelines for Federally Qualified Health Clinics (FQHCs) effective March 6, 2026. Key changes include requiring MCOs to accept valid FQHC claims regardless of primary care provider designation, mandating G-encounter codes on first claim lines for shadow billing, and removing telehealth guidance to reference separate instructions.
Action Required
Immediately: FQHCs in Nevada must update billing procedures to place G-encounter codes on the first claim line for all shadow billing submissions. Review and implement the updated Provider Type 17 Specialty 181 billing guide available on the Nevada Medicaid Billing Information page. For telehealth billing, reference the separate Telehealth Billing Instructions rather than the PT 17 guidelines.