MedicaidCoverageMedium impact
Nebraska Medicaid Coverage Limits for Adult Rehabilitation Therapy Services
Nebraska Medicaid·NE · Physical Therapy, Occupational Therapy, Speech Therapy +1 more·Medical Policy
Effective date
Jul 1, 2026
We identified it
Jun 21, 2026
Summary
Starting July 1, 2026, Nebraska Medicaid will only count rehabilitation therapy sessions (PT/OT/Speech) toward the 60-session annual limit when Medicaid is the primary payer. Sessions covered by Medicare or private insurance first will no longer count against this limit, effectively providing more Medicaid-covered therapy sessions for patients with other insurance.
Action Required
By July 1, 2026: Billing team must update therapy session tracking to only count PT/OT/Speech visits toward Nebraska Medicaid's 60-session limit when Medicaid is primary payer. Update billing system logic to exclude sessions where Medicare or private insurance paid any amount. Train staff on new payer hierarchy rules for therapy visit counting.