MedicaidCoverageMedium impact
Expansion of Medicaid Coverage to Include Medically Necessary Abortions
Nevada Medicaid·NV · OB-GYN, Family Medicine, Emergency Medicine·Provider Announcement
Effective date
Dec 16, 2024
We identified it
Jun 21, 2026
Summary
Nevada Medicaid expanded coverage for medically necessary abortions effective December 16, 2024, requiring prior authorization for most procedures and specific condition codes on all abortion claims. Claims without proper condition codes or using excluded codes (AH, AC, AG, Z33.2) will be denied.
Action Required
Immediately: Billing team must update Nevada Medicaid abortion claims to include required condition codes (AA, AB, AD, AE, AF). Submit prior authorization using Form FA-6 for medically necessary abortions except for rape, incest, or life-threatening cases. Ensure claims do not use condition codes AH, AC, AG or diagnosis code Z33.2 as these will result in automatic denials.