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Nevada MedicaidMedicaid · Billing Codes · Billing & Coding · NVHigh impact

Medicaid Management Information System Updated with NCCI Quarter 4 2026 Files

Act
by Sep 30, 2026
Effective date
Oct 1, 2026
Identified
Sep 23, 2026

Summary

Nevada Medicaid's MMIS has been updated with CMS NCCI Quarter 4 2026 files effective October 1, 2026. The system will now apply updated Medically Unlikely Edits (MUE) and Procedure-to-Procedure (PTP) edits to process claims. Billing teams must ensure correct modifier combinations and code pairings are used to prevent claim denials.

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What to do

by Sep 30, 2026 · 3 steps
01Billing team must review current NCCI edit files from the CMS Medicaid NCCI webpage (https://www.cms.gov/medicare/coding-billing/ncci-medicaid) to identify any changes affecting your practice's commonly billed procedures.
02Update billing software and staff training to ensure all claims submitted on or after October 1, 2026 use correct modifier combinations and valid code pair combinations.
03Verify that encounter forms and billing templates reflect proper coding guidelines.
If missed: Failure to comply will result in claim denials and payment delays for Nevada Medicaid beneficiaries.

Original notice

Medicaid Management Information System Updated with NCCI Quarter 4 2026 Files
medicaid.nv.gov · Always check the source before changing claims.
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Related changes

See all Nevada Medicaid changes →
Medicaid Management Information System Updated with NCCI Quarter 3 2024 FilesMediumEffective Jul 1, 2024 · Billing & CodingMedicaid Management Information System Updated with NCCI Quarter 4 2024 FilesMediumEffective Oct 1, 2024 · Billing & CodingMedicaid Management Information System Updated with NCCI Quarter 1 2025 FilesMediumEffective Jan 1, 2025 · Billing & CodingMedicaid Management Information System Updated with NCCI Quarter 2 2025 FilesMediumEffective Apr 1, 2025 · Billing & CodingBrowse every Nevada Medicaid change in the policy list

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