MedicaidCoverageMedium impact
Attention Providers Serving Healthy Kids or Nevada Check Up Recipients: Lead Testing Guidance according to the American Academy of Pediatrics (AAP) Bright Future’s Periodicity Schedule
Nevada Medicaid·NV · Pediatrics, Family Medicine·Provider Announcement
Effective date
Aug 8, 2025
We identified it
Jun 21, 2026
Summary
Nevada Medicaid clarifies lead testing guidelines for pediatric patients, specifying that blood lead assessments are included in routine EPSDT/Healthy Kids checkups and outlining specific CPT codes for reimbursement when separate lead testing is medically indicated.
Action Required
Immediately: Billing team should verify that blood lead assessments are not separately billed during routine EPSDT/Healthy Kids checkups for Nevada Medicaid patients, as they are included in the exam. When separate lead testing is medically indicated, ensure CPT codes 36415 (venous collection), 36416 (capillary collection), and 83655 (blood lead test) are used appropriately and verify CLIA waiver requirements for in-office testing.