MedicaidBilling CodesLow impact
Attention Provider Type 60 (School Health Services): Claims for Procedure Code 92551 with Modifier 52
Nevada Medicaid·NV · Audiology·Billing & Coding
Effective date
Jul 30, 2024
We identified it
Jun 21, 2026
Summary
Nevada Medicaid no longer requires modifier 52 on CPT 92551 (pure tone hearing test) claims from School Health Services providers. Claims from June 28, 2023 through July 29, 2024 will be automatically reprocessed for correct payment.
Action Required
Nevada School Health Services providers only: Update billing system to remove modifier 52 requirement for CPT 92551 pure tone hearing tests effective July 30, 2024. Use modifier 52 only when test is performed on one ear instead of two. Monitor future remittance advice for automatic reprocessing results of claims from June 2023-July 2024.