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Error Codes 5612 and 5619 Updated for Current Procedural Terminology (CPT) Codes 92510–97761
Act
immediately
Effective date
Nov 25, 2024
Identified
Jun 21, 2026
Summary
Nevada Medicaid updated error codes 5612 and 5619 that limit therapy encounters per year, removing restrictions from 11 specific therapy CPT codes and shifting encounter limits from therapy facilities to physician/provider types. Additionally, four cochlear implant codes no longer require prior authorization when billed by therapy providers.
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What to do
immediately · 3 steps
01Update billing system to reflect that error codes 5612 and 5619 (encounter limits) no longer apply to CPT codes 92510, 97124, 97533, 97033, 97034, 97036, 97113, 97530, 97542, 97760, and 97761.
02Configure system so encounter limits now apply to physicians (PT 20, 21, 24, 36, 74, 76, 77) instead of therapy facilities (PT 12, 17, 34) for specified therapy codes.
03Remove prior authorization requirements for cochlear implant codes 92601-92604 when billed by therapy providers (PT 34).
Codes mentioned
92510971249753397033970349703697113975309754297760977619260192602926039260497010970129701497016970189702297024970269702897032970359711097112971169715097535
Original notice
Error Codes 5612 and 5619 Updated for Current Procedural Terminology (CPT) Codes 92510–97761
medicaid.nv.gov · Always check the source before changing claims.
Related changes
See all Nevada Medicaid changes →Attention Provider Types 34 (Therapy) and 85 (Applied Behavior Analysis): Some Procedure Codes Billed with Place of Service Code 10 Now Deny With Error Code 679HighEffective Sep 23, 2024 · Provider AnnouncementUpdates to Limitation Error CodesHighEffective Apr 28, 2025 · Provider AnnouncementAttention Provider Type 60 (School Health Services): Ordering, Prescribing and Referring Requirements UpdatedMediumEffective Mar 9, 2026 · Provider EnrollmentAttention Provider Types 24 (Advanced Practice Registered Nurses) and 77 (Physician’s Assistant): Service Limitations UpdatedMediumEffective Nov 10, 2025 · Provider AnnouncementBrowse every Nevada Medicaid change in the policy list
Related policy hubs
Nevada Medicaid policiesNV policy changesPhysical TherapyOccupational TherapyAudiologyPM&R (Physical Medicine & Rehab)ChiropracticCode 92510Code 97124Code 97533Code 97033Code 97034Code 97036Code 97113Code 97530Code 97542Code 97760Code 97761Code 92601Code 92602Code 92603Code 92604Code 97010Code 97012Code 97014Code 97016Code 97018Code 97022Code 97024Code 97026Code 97028Code 97032Code 97035Code 97110Code 97112Code 97116Code 97150Code 97535