MedicaidBilling CodesHigh impact
Attention Provider Type 47 (Indian Health Services and Tribal Clinics): Use Modifier SE for Claims for Non-American Indian/American Native Members
Nevada Medicaid·NV·Billing & Coding
Effective date
Jun 15, 2026
We identified it
Jun 21, 2026
Summary
Starting June 15, 2026, Indian Health Services and Tribal Clinics (Provider Type 47) must add modifier SE when billing encounter code T1015 for non-American Indian/Alaskan Native members. Claims for American Indian/Alaskan Native members continue to be billed without the modifier.
Action Required
By June 15, 2026: Indian Health Services and Tribal Clinics must update billing system to automatically append modifier SE to encounter code T1015 when services are provided to non-American Indian/Alaskan Native members. Train billing staff to verify patient ethnicity before claim submission. Update encounter forms and billing protocols to ensure proper modifier usage. Claims without proper modifier may be denied.