FEDERAL MEDICAID POLICY

All children enrolled in Medicaid, regardless of whether coverage is funded through title XIX or XXI, are required to receive blood lead tests at ages 12 months and 24 months. Any child between 24 and 72 months with no record of a previous blood lead screening test must receive one.

Completion of a risk assessment questionnaire does not meet the Medicaid requirement. The Medicaid requirement is met only when the two blood lead screening tests (or a catch-up blood lead test) are conducted. Blood lead tests may be done with either capillary or venous specimens.

NEVADA STATE LAW

In Nevada, childhood blood lead screening laws are defined by the Nevada Revised Statutes (NRS) 442.700. In summary, NRS 442.700 states the following:

1. Each provider of health care or other services who:
   1. Is qualified to conduct a blood lead test is encouraged to perform, or cause to be performed, a test when a child reaches 12 and 24 months, or at least once before the child reaches 6 years of age,
   2. Provides early and periodic screening, diagnostic and treatment services to children is encouraged to conduct a blood lead test in accordance with the guidelines of the Centers for Medicare and Medicaid Services
2. Any blood lead test performed using a capillary sample that results in a blood lead level greater than the reference value should be confirmed by a follow-up venous blood lead test.
3. All blood lead tests, regardless of results, should be reported to the appropriate health authority. The report must include:
   1. The name, sex, race, ethnicity and date of birth of the child
   2. The address of the child, including the county and zip code
   3. The date on which the sample was collected
   4. The type of sample that was collected
   5. The name and contact information of the health care provider who ordered the test

To screen children who are not enrolled in Medicaid, a Childhood Lead Risk Questionnaire (CLRQ) may be used. The CLRQ is a tool used to assess the risk of potential exposure during well-child visits. The American Academy of Pediatrics (AAP) Bright Futures Periodicity Schedule recommends that providers screen children at: 6 months, 9 months, 12 months, 18 months, 24 months, and at 3, 4, 5, and 6 years of age. If the answer to any question on the screening tool is “Yes” or “Don’t know,” a blood lead test should be performed.

Billing and Coverage

CPT Codes: 36415 (collection of venous sample), 36416 (collection of capillary sample), 83655 (blood lead test)

Codes 36415 and 36416 cannot be billed on the same day for the same patient in conjunction with 83655.

Clinics may perform testing in-house (with a valid CLIA waiver) or refer to an external lab.

Lead screening is covered under Medicaid and Nevada Check Up as part of the standard preventive exam and requires no prior authorization.

Sources

• Nevada Medicaid Web Announcements 3692 (August 8, 2025)
• Nevada Medicaid Web Announcements 3746 (October 17, 2025)
• Nevada Revised Statute 442.700
• American Academy of Pediatrics, Bright Futures Periodicity Schedule (2023 Update)
• Centers for Medicare & Medicaid Services (CMS), EPSDT Requirements.