MedicaidBilling CodesHigh impact
Attention Provider Type 17 (Special Clinics) Specialties 180 (Rural Health Clinics), 181 (Federally Qualified Health Centers), and 182 (Indian Health Services, Urban Indian Organizations): Long-Acting Reversible Contraception (LARC) Updates
Nevada Medicaid·NV · OB-GYN, Family Medicine·Provider Enrollment
Effective date
Mar 18, 2025
We identified it
Jun 21, 2026
Summary
Nevada Medicaid now requires modifier 25 when billing medical encounters (G0466, G0467, G0468) with Long-Acting Reversible Contraception (LARC) services for special clinics. Providers must also bill their usual and customary amounts for LARC services, as claims billed at $0.00 will be paid $0.00.
Action Required
Immediately: Billing team must update system to require modifier 25 on encounter codes G0466, G0467, or G0468 when billed with LARC procedure codes 58300, 58301, 11981, 11982, or 11983. Update billing rules to ensure usual and customary amounts are billed for all LARC services - claims billed at $0.00 will be paid $0.00. Claims without modifier 25 will deny with error code 7216.