MedicaidPrior AuthMedium impact
Attention Provider Type 89 (Community Healthcare Workers): Update to Error Codes for Service Limitations
Nevada Medicaid·NV · Family Medicine, General Practice·Provider Enrollment
Effective date
Feb 18, 2025
We identified it
Jun 21, 2026
Summary
Nevada Medicaid updated error codes for Community Healthcare Workers (Provider Type 89) effective February 18, 2025. CHWs can now submit prior authorization requests to exceed daily and monthly service limits for patient education codes 98960-98962, with new PA override error codes replacing automatic denials.
Action Required
Immediately: Community Healthcare Workers in Nevada must update billing workflows to submit prior authorization requests through EVS when exceeding 4 units per day or 24 units per month for CPT codes 98960, 98961, and 98962. Train staff on new error codes 5686 and 5743 which indicate PA override requirements rather than automatic denials.