MedicaidBilling CodesHigh impact
Attention Provider Type 17 (Special Clinics) Specialty 181 (Federally Qualified Health Center): New Shadow Billing Requirements Effective January 1, 2026
Nevada Medicaid·NV · Family Medicine, Internal Medicine, Psychiatry·Billing & Coding
Effective date
Jan 1, 2026
We identified it
Jun 21, 2026
Summary
Starting January 1, 2026, Nevada Medicaid requires shadow billing for Federally Qualified Health Centers (FQHCs). Medical encounters using codes G0466-G0468 must include at least one qualified medical shadow code, and behavioral health encounters using G0469-G0470 must include at least one qualified behavioral health shadow code.
Action Required
By January 1, 2026: FQHC billing teams must update billing system to require shadow codes with encounter codes - medical encounters (G0466, G0467, G0468) must include at least one qualified medical shadow code, and behavioral health encounters (G0469, G0470) must include at least one qualified behavioral health shadow code. Obtain shadow billing code list from Nevada FQHC webpage. Claims will deny with error code 6500 if shadow billing requirements are not met.