MedicaidBilling CodesMedium impact
Attention Provider Type 38 (Waiver for Individuals with Intellectual and Developmental Disabilities): Procedure Code S5190 May Be Billed With New Modifiers U2, U3, and U4
Nevada Medicaid·NV · Psychiatry, General Practice·Provider Enrollment
Effective date
Oct 1, 2024
We identified it
Jun 21, 2026
Summary
Nevada Medicaid now allows Provider Type 38 (Waiver for Individuals with Intellectual and Developmental Disabilities) to bill procedure code S5190 with new time-based modifiers U1, U2, U3, and U4 for individual and group wellness assessments. This expands billing options for wellness assessments performed by non-physicians with specific time increments from 15 to 60 minutes.
Action Required
Immediately (effective since October 1, 2024): Billing team must update Nevada Medicaid billing system to include new modifiers U2, U3, and U4 for individual wellness assessments with S5190, and modifier combinations U1+U2, U1+U3, U1+U4 for group sessions. Update encounter forms for Provider Type 38 to include time-based modifier options (15, 30, 45, 60 minutes). This only applies to practices serving individuals with intellectual and developmental disabilities under Nevada Medicaid waiver programs.