MedicaidCoverageMedium impact
Reminder to Provider Types 12 (Hospital, Outpatient), 43 (Laboratory), and 96 (Rural Emergency Hospital): Procedure Code 81420 Open for Billing Effective January 1, 2026
Nevada Medicaid·NV · OB-GYN, Genetics·Billing & Coding
Effective date
Jan 1, 2026
We identified it
Jun 21, 2026
Summary
Nevada Medicaid will cover Noninvasive Prenatal Testing (NIPT) using CPT code 81420 starting January 1, 2026. Hospitals, laboratories, and rural emergency hospitals can bill this code without prior authorization, with a limit of 1 unit per 3 rolling months.
Action Required
Before January 1, 2026: Billing teams at hospitals, laboratories, and rural emergency hospitals must update billing systems to accept CPT code 81420 for Nevada Medicaid claims. Configure system to enforce service limitation of 1 unit per 3 rolling months. Update encounter forms and staff training materials to reflect no prior authorization requirement for this code.