MedicaidAdministrativeMedium impact
Removal of Third-Party Liability Edits
Nebraska Medicaid·NE · Psychiatry·Provider Bulletin
Effective date
Jun 18, 2025
We identified it
Jun 21, 2026
Summary
Nebraska Medicaid providers no longer need to bill Medicare first for specific mental health and substance use services (19 specific codes) for Heritage Health members with Medicare coverage, but must now bill commercial insurance first for these same services when commercial is primary.
Action Required
Effective June 18, 2025: Billing team must update system workflows for Heritage Health members - remove Medicare primary billing requirement for the 19 listed mental health/substance use codes when Medicare is primary, but add commercial insurance primary billing requirement for these same codes when commercial insurance is primary. Update billing software rules and train staff on the reversed requirements.