MedicaidPrior AuthMedium impact
Attention Provider Type 90 (Doula Services): Update to Error Code Applicable to Procedure Code S9445
Nevada Medicaid·NV · OB-GYN·Provider Enrollment
Effective date
Nov 4, 2024
We identified it
Jun 21, 2026
Summary
Nevada Medicaid changed the error code for procedure code S9445 (patient education by non-physician providers) when the 4-unit limit per 13 months is exceeded. Claims will now deny with error code 5741 instead of 5721, and prior authorization is required to exceed the limit.
Action Required
Immediately: Billing team must update system to expect error code 5741 (instead of 5721) when procedure code S9445 exceeds 4 units per 13 months. Update workflows to obtain prior authorization before billing more than 4 units of S9445 per patient in any rolling 13-month period. Claims exceeding limits without PA will be denied.