MedicaidAdministrativeMedium impact
Medicaid Services Manual Chapter 2800 Updated
Nevada Medicaid·NV · Pediatrics, Family Medicine, General Practice·Provider Announcement
Effective date
Apr 29, 2026
We identified it
Jul 3, 2026
Summary
Nevada Medicaid updated School Health Services (SHS) policy effective April 29, 2026. Key changes include: age eligibility expanded from 3–21 to under 21 years; a new limited exception to Ordering, Prescribing, and Referring (OPR) requirements for registered nurses (RN); clarified third-party liability (TPL) pay and chase requirements; and a new Program Compliance section. Billing teams must review the full Chapter 2800 to understand RN authorization changes and TPL processing impacts.
Action Required
By August 1, 2026: Billing and clinical teams must review the full Nevada Medicaid Services Manual Chapter 2800 (available at https://www.nevadamedicaid.nv.gov/resources/medicaid-services-manual/chapter-2800-school-health-services/) to understand: (1) the new RN OPR exception and how it affects ordering/prescribing workflows, (2) updated TPL pay and chase requirements and how they impact claim processing, and (3) new compliance requirements in Section 2803.7. Update internal billing workflows, staff training, and school health service encounter forms to reflect RN authorization changes. Verify that billing system correctly processes TPL according to revised requirements. Non-compliance may result in claim denials or recoupment.