MedicaidCoverageMedium impact
Attention 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 begin covering Noninvasive Prenatal Testing (NIPT) effective January 1, 2026. Hospital outpatient departments, laboratories, and rural emergency hospitals can bill CPT code 81420 for fetal chromosomal aneuploidy testing with no prior authorization required and a limit of 1 unit per 3 rolling months.
Action Required
Before January 1, 2026: Billing team must add CPT code 81420 to Nevada Medicaid fee schedule in billing system for provider types 12 (Hospital Outpatient), 43 (Laboratory), and 96 (Rural Emergency Hospital). Configure system to limit billing to 1 unit per 3 rolling months. Update encounter forms to include new code for NIPT testing.