MedicaidBilling CodesMedium impact
Attention Provider Types 11 (Hospital, Inpatient) and 75 (Critical Access Hospital): Long-Acting Reversible Contraception Devices Services Now Open For Billing
Nevada Medicaid·NV · OB-GYN·Billing & Coding
Effective date
Mar 31, 2025
We identified it
Jun 21, 2026
Summary
Effective March 31, 2025, Nevada hospitals (Provider Types 11 and 75) can now bill for Long-Acting Reversible Contraception (LARC) services outside of per diem rates under Fee-for-Service Medicaid. These services must be billed as outpatient claims by their PT 12 location and can be billed concurrently with inpatient stays.
Action Required
Immediately: Nevada hospitals (PT 11 and 75) must update billing workflows to submit LARC services as outpatient claims through their PT 12 location. Billing team must ensure NDC codes are included with all J-code drug claims (J7296-J7307) and track service limitations (2 units per day for insertions/removals, 2 units per 3 years for implants). Prior authorization required to exceed service limits for codes 11981 and 11983. Claims from January 1, 2024 forward that previously denied will be automatically reprocessed.