MedicaidBilling CodesMedium impact
Attention Provider Type 91 (Pharmacist): Opioid Use Disorder (OUD) Procedure Codes
Nevada Medicaid·NV · Pharmacy·Provider Enrollment
Effective date
Aug 19, 2024
We identified it
Jun 21, 2026
Summary
Nevada Medicaid now allows pharmacists (Provider Type 91) to bill for opioid use disorder assessment and treatment services using consultation codes 99242-99245 and prolonged service code 99417, with reimbursement equal to physician rates. Claims must include modifier U5 and appropriate OUD diagnosis codes.
Action Required
By August 19, 2024: Billing team must update system to allow Provider Type 91 (Pharmacists) to bill CPT codes 99242, 99243, 99244, 99245, and 99417 for Nevada Medicaid OUD services. Configure system to require modifier U5 and OUD diagnosis codes for these claims. Update encounter forms for pharmacist providers performing MAT services.