Covered services

Anthem Blue Cross and Blue Shield Healthcare Solutions (Anthem) covers healthcare services based on the Medicaid fee schedule. Services covered will be administered up to the limits/guidance as outlined in the appropriate Nevada Medicaid Service Manuals. Under the rules of the Nevada Medicaid Services Manual, some services are limited by number of provider visits or by number of supply and equipment items.

Some procedure codes on the Medicaid fee schedule do not have rates loaded and will show with a $0.00 rate. Procedure codes with a $0.00 rate are reimbursed at 62% of usual and customary charges unless noted otherwise in Nevada Medicaid policy.

If a procedure code is not listed on the fee schedule, it is considered a non-covered code. Non-covered codes are not reimbursable and if billed, will deny.

We encourage providers to stay informed on Anthem policies, processes, and news by utilizing our website at https://providers.anthem.com/nv.