MedicaidCoverageMedium impact
Changes to Coverage for Therapeutic and Medical Leave Days
Nebraska Medicaid·NE · Psychiatry·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 21, 2026
Summary
Nebraska Medicaid will no longer reimburse therapeutic or medical leave days for secure psychiatric residential rehabilitation (SPRR), assertive community treatment (ACT), and therapeutic group home (THGH) programs effective January 1, 2026. This change eliminates a previously covered service category.
Action Required
By January 1, 2026: Billing team must stop submitting claims for therapeutic and medical leave days for SPRR, ACT, and THGH programs to Nebraska Medicaid. Update billing software to flag these services as non-covered. Notify providers that these leave days are no longer reimbursable and will result in claim denials.