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MedicaidAdministrativeMedium impact

Medicaid Management Information System Updated with NCCI Quarter 2 2025 Files

Nevada Medicaid·NV·Billing & Coding
Effective date
Apr 1, 2025
We identified it
Jun 21, 2026
Days to comply

Summary

Nevada Medicaid has updated its system with CMS NCCI Quarter 2 2025 files, which include new Medically Unlikely Edits (MUE) and Procedure-to-Procedure (PTP) edits that will affect claim processing. These updates will prevent improper payments when incorrect code combinations are reported or service limitations are exceeded.

Action Required

Action needed
Before April 1, 2025: Billing team must review current Nevada Medicaid claims for code combinations that may be affected by new NCCI edits. Verify all procedure codes are billed with correct modifier combinations and appropriate units of service. Monitor initial claims submissions after April 1st for any new denials related to NCCI edits and adjust billing practices accordingly.