MedicaidPrior AuthMedium impact
Attention Provider Type 33 (Durable Medical Equipment, Prosthetics, Orthotics and Disposable Medical Supplies): Prior Authorization Requirements Updated
Nevada Medicaid·NV·Prior Authorization
Effective date
Nov 10, 2025
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has updated prior authorization requirements for durable medical equipment providers, removing PA requirements for ostomy pouches (A4420) and moisture exchangers (A4483), while updating rates for reusable underpads and clarifying that certain diaper codes are non-covered services.
Action Required
Immediately: DMEPOS billing staff must update billing system to remove prior authorization requirements for codes A4420 and A4483. Update rate schedules for codes T4537 and T4540 effective November 10, 2025. Ensure codes T4536, T4538, and T4539 are marked as non-covered services. Submit invoices per Web Announcement 3588 requirements for A4420 and A4483 services.