MedicaidBilling CodesMedium impact
Attention Provider Types 17 (Special Clinics) Specialties 181 (Federally Qualified Health Clinics) and 198 (HIV), and 74 (Nurse Midwife): Syphilis Testing Codes Open for Billing Beginning January 1, 2026
Nevada Medicaid·NV · OB-GYN, Infectious Disease·Billing & Coding
Effective date
Jan 1, 2026
We identified it
Jun 21, 2026
Summary
Nevada Medicaid now allows specific provider types (FQHCs, HIV specialty clinics, and nurse midwives) to bill for syphilis testing in pregnant individuals. Two new CPT codes (86592 and 86780) are now billable without prior authorization for these provider types only.
Action Required
By January 1, 2026: Billing teams at FQHCs, HIV specialty clinics, and nurse midwife practices must update billing systems to allow CPT codes 86592 and 86780 for syphilis testing in pregnant patients. FQHCs must configure shadow billing only for these codes. Verify provider type and specialty codes are correctly set up in billing system to ensure proper claim processing.