Nevada Medicaid FeeForService (FFS) Fee Schedule Update

Overview

The Nevada Department of Health and Human Services (DHHS) released its annual Medicaid FeeForService (FFS) fee schedule update on April 15, 2024. The update reflects adjustments to reimbursement rates for a wide range of services, including physician office visits, laboratory tests, imaging, and specialty procedures. The changes are driven by the latest Medicare Economic Index (MEI), costofliving adjustments, and state policy priorities aimed at enhancing access to care while maintaining fiscal responsibility.

All Nevada Medicaid providers who bill under the FFS model must transition to the new schedule by **July 1, 2024**. The update supersedes the previous schedule that was effective July1,2023.

Key Changes

Below are the most significant revisions in the 2024 fee schedule:

Additional highlights:

• All CPTbased services received a uniform 6% increase aligning with the MEI.
• Rural health provider adjustments were added for telehealth visits, providing a 10% bonus when services are rendered to patients in designated Rural Health Clinics.
• New valueadded code for digital health monitoring (CPT99091) now reimbursed at $22.00 per 20minute interval.
• Revised bundled payment amounts for certain surgical episodes to encourage care coordination.

Impact on Providers

The fee schedule update has several practical implications:

Revenue Projections

Most primary care and specialty services saw modest increases (68%). Providers who heavily rely on highvolume laboratory and imaging procedures will notice a larger absolute increase due to higher base rates.

Rural & Telehealth Practices

The targeted rural telehealth bonus is expected to improve provider participation in remote care, especially for chronic disease management.

Compliance Requirements

To avoid claim rejections, providers must:

• Update electronic health record (EHR) fee tables by June15,2024.
• Verify that all claim editing software reflects the new CPTMEI adjustments.
• Submit a Fee Schedule Update acknowledgment through the Medicaid Provider Portal.

Potential Challenges

• Smaller practices may need technical assistance to modify billing systems.
• Some contractually negotiated rates with managed care organizations (MCOs) may not automatically align with the FFS update, requiring separate renegotiation.

Implementation Timeline

Resources

For additional information and support:

• Full 2024 FFS Fee Schedule (PDF)
• Medicaid Provider Updates page
• Monthly provider webinars register here
• Technical assistance hotline: 18005550101 (MonFri, 8am5pm)
• Contact your regional Medicaid office for personalized support.