MedicaidBilling CodesMedium impact
Attention Provider Type 38 (Waiver for Individuals with Intellectual and Developmental Disabilities): Procedure Code T2025 Modifiers are Replacing Procedure Code T2017 Modifiers When Billed with T2016
Nevada Medicaid·NV · General Practice·Provider Enrollment
Effective date
Jun 30, 2024
We identified it
Jun 21, 2026
Summary
Nevada Medicaid is replacing procedure code T2017 with T2025 when billed with T2016 for waiver services for individuals with intellectual and developmental disabilities. The billing team must use the new T2025 modifier combinations and resubmit any previously denied claims that used T2017 modifiers.
Action Required
Immediately: For Provider Type 38 (Waiver for Individuals with Intellectual and Developmental Disabilities), billing team must update system to use T2025 modifiers instead of T2017 when billing with T2016. Replace T2017 HN with T2025 HN, UD; T2017 HN TN with T2025 HN, TN, UD; T2017 HM with T2025 HM, UD; T2017 HM TN with T2025 HM, TN, UD. Discontinue use of T2017 GF (obsolete). Resubmit all claims with T2017 modifiers from January 1, 2024 forward that denied with error code 5093. Claims will not be automatically reprocessed.