MedicaidAdministrativeHigh impact
Update to APRN Provider Enrollment and Behavioral Health Services
Nebraska Medicaid·NE · Psychiatry, Family Medicine, Internal Medicine·Enrollment
Effective date
Jan 1, 2025
We identified it
Jun 21, 2026
Summary
Nebraska Medicaid now requires APRNs to be enrolled under mental health specialty and affiliated with qualified provider groups to bill behavioral health services. Specific CPT codes have different enrollment requirements based on patient diagnoses.
Action Required
Immediately: APRNs providing behavioral health services must enroll under mental health specialty with Maximus (1-844-374-5022 or nebraskamedicaidPSE@maximus.com) and be affiliated with hospitals, clinics, or professional clinics enrolled under psychiatric/mental health/substance abuse specialty. Contact managed care organizations to ensure credentialing for behavioral health services. For codes 96130-96139, mental health enrollment is required only when patients have mental health or substance use diagnoses.