MedicaidBilling CodesMedium impact
Claims for Sleep Study Procedure Codes Billed With Modifier TC or Modifier 26
Nevada Medicaid·NV · Sleep Medicine, Pulmonology·Billing & Coding
Effective date
Mar 24, 2025
We identified it
Jun 21, 2026
Summary
Nevada Medicaid now requires sleep study procedure codes to be billed with modifier TC (Technical Component) or modifier 26 (Professional Component) when providers perform only a portion of the service. The same practitioner cannot bill both modifiers for the same procedure on the same date for the same patient.
Action Required
Immediately: Billing team must update Nevada Medicaid claims to include modifier TC or 26 when billing sleep study codes 95782, 95783, 95805-95811, 95819, and 95822 for partial services only. Update billing system to prevent same practitioner from billing both TC and 26 modifiers for same procedure/date/patient. Train staff on appropriate modifier usage based on provider type restrictions.