MedicaidPrior AuthMedium impact
Attention All Providers Who Perform Long-Acting Reversible Contraception (LARC) Services: Service Limitation Update for Procedure Codes 11981 and 11983
Nevada Medicaid·NV · OB-GYN, Family Medicine·Provider Announcement
Effective date
Jan 1, 2024
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has updated service limitations for long-acting reversible contraception (LARC) procedures, restricting codes 11981 and 11983 to 2 units per 3 rolling years with prior authorization required to exceed this limit. Claims exceeding the limit without prior authorization will be denied with error code 5744.
Action Required
Immediately: Billing team must update system to track units for CPT codes 11981 and 11983, limiting to 2 units per 3 rolling years for Nevada Medicaid patients. Implement prior authorization workflow for cases exceeding this limit. Train staff to recognize error code 5744 (2 units allowed per 3 rolling years - PA override) and obtain prior authorization before resubmission.