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MedicaidBilling CodesMedium impact

Quarter 4 2025 New Code Update

Nevada Medicaid·NV·Provider Announcement
Effective date
Oct 1, 2025
We identified it
Jun 21, 2026
Days to comply

Summary

Nevada Medicaid has added new Quarter 4 2025 CPT, HCPCS, and ADA codes to their system effective October 1, 2025. Claims using these new codes will suspend with error 853 until rates and policies are updated, but providers can submit retroactive prior authorization requests during this transition period.

Action Required

Action needed
Starting October 1, 2025: Use new Quarter 4 2025 CPT, HCPCS, and ADA codes for applicable services. Billing team should expect claims with new codes to suspend with error 853 until Nevada Medicaid updates rates and policies. Monitor for additional web announcements regarding when suspended claims will be released. Submit retroactive prior authorization requests as needed for new codes requiring prior auth.