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Attention Provider Types 11 (Hospital, Inpatient) and 75 (Critical Access Hospital): Long-Acting Reversible Contraception Devices Services Now Open For Billing
Act
immediately
Effective date
Mar 31, 2025
Identified
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.
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What to do
immediately · 4 steps
01Nevada hospitals (PT 11 and 75) must update billing workflows to submit LARC services as outpatient claims through their PT 12 location.
02Billing 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).
03Prior authorization required to exceed service limits for codes 11981 and 11983.
04Claims from January 1, 2024 forward that previously denied will be automatically reprocessed.
Codes mentioned
5830058301119811198211983J7296J7297J7298J7300J7301J7307
Original notice
Attention Provider Types 11 (Hospital, Inpatient) and 75 (Critical Access Hospital): Long-Acting Reversible Contraception Devices Services Now Open For Billing
medicaid.nv.gov · Always check the source before changing claims.
Related changes
See all Nevada Medicaid changes →Attention Provider Type 17 Specialties 180 (Rural Health Clinics) and 181 (Federally Qualified Health Centers): Long-Acting Reversible Contraception (LARC) Devices Services AvailableMediumEffective Jan 1, 2024 · Provider EnrollmentAttention Provider Types 11 (Hospital, Inpatient) and 75 (Critical Access Hospital): Long-Acting Reversible Contraception Devices Services Will Be Opened for BillingMediumNo effective date · Billing & CodingAttention Provider Type 17 (Special Clinics) Specialty 182 (Indian Health Services (IHS), Urban Indian Organizations): Long-Acting Reversible Contraception (LARC) Devices Services AvailableLowEffective Jan 1, 2024 · Provider EnrollmentAttention 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) UpdatesHighEffective Mar 18, 2025 · Provider EnrollmentBrowse every Nevada Medicaid change in the policy list