MedicaidBilling CodesHigh impact
Changes to Billing Procedures for Specialty-Based PRTFs
Nebraska Medicaid·NE · Psychiatry·Claims & Billing
Effective date
Jul 1, 2025
We identified it
Jun 21, 2026
Summary
Nebraska Medicaid is discontinuing HCPCS code T2033 for specialty-based PRTFs effective July 1, 2025. Non-hospital-based PRTFs must now use code T2048 (community-based billing code) with reimbursement adjusted to match the previous specialty rate of $448.31.
Action Required
Immediately: Billing team must stop using HCPCS code T2033 for all non-hospital-based PRTF claims and switch to T2048. Update billing software to use T2048 for specialty PRTFs with reimbursement rate of $448.31. Hospital-based PRTFs continue using H2013. Contact DHHS.MedicaidMHSU@nebraska.gov with questions.