MedicaidBilling CodesMedium impact
Attention Provider Types 10 (Outpatient Surgery, Hospital Based), 12 (Hospital, Outpatient), and 46 (Ambulatory Surgical Centers): Procedure Codes C1767 and C1778 Opened for Billing
Nevada Medicaid·NV · Neurology, Neurosurgery·Billing & Coding
Effective date
Mar 1, 2026
We identified it
Jun 21, 2026
Summary
Nevada Medicaid now allows billing for vagus nerve stimulation (VNS) therapy device codes C1767 and C1778 for refractory epilepsy treatment by outpatient surgery centers, hospitals, and ambulatory surgical centers. These devices will be reimbursed at 82% of acquisition cost and require prior authorization plus specific refractory epilepsy diagnosis codes.
Action Required
Before March 1, 2026: Billing team must update system to require prior authorization for surgery codes 61885, 64568, 64569, and 64570 when billing device codes C1767 and C1778. Update billing workflow to collect acquisition cost invoices (must be less than 180 days old) and verify one of the specified refractory epilepsy diagnosis codes is present. Claims for devices will be denied without approved prior authorization for the associated surgery.