MedicaidCoverageMedium impact
Attention Provider Type 60 (School Health Services (SHS)): Claims for Procedure Code 92551 No Longer Deny with Error Code 5506
Nevada Medicaid·NV · Audiology·Provider Enrollment
Effective date
Sep 16, 2024
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has removed the frequency limitation for CPT code 92551 (pure tone hearing test) for School Health Services providers. Claims that previously denied due to the 1 unit per 12 months limit will now be accepted and previously denied claims will be automatically reprocessed.
Action Required
Immediately: School Health Services providers (PT 60) can now bill CPT 92551 (pure tone hearing test) multiple times within 12 months without frequency denials. Update billing procedures to remove internal frequency limits for this code. Monitor future remittance advice for automatic reprocessing of previously denied claims from November 1, 2023 through September 16, 2024.