Reimbursement for nitrous oxide during in-office medical procedures effective Aug. 1, 2026

By August 1, 2026: (1) Billing team must update billing software to enable claims submission for nitrous oxide using CPT code 01999 with modifier QS. (2) Verify that the system recognizes the $44.08 reimbursement rate for OHP claims. (3) Train providers and clinical staff on proper coding and documentation requirements for nitrous oxide administration during in-office procedures. (4) For CCO-contracted providers: notify your contracted CCOs that claims processing systems must be configured to reimburse nitrous oxide for in-office medical procedures. (5) Update encounter forms and billing checklists to include nitrous oxide as a billable service option. Claims submitted without the QS modifier or using incorrect codes may be denied or delayed.