MedicaidPrior AuthMedium impact
Reminder to Provider Type 34 (Therapy) Specialties 29 (Speech Pathologist) and 219 (Speech Pathologist Language): Prior Authorization Requirements Removed for Certain Speech Therapy Services
Nevada Medicaid·NV · Speech Therapy·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has removed prior authorization requirements for specific speech therapy services for patients under age 26 diagnosed with stuttering disorders, effective January 1, 2026. This applies to 12 specific CPT codes when treating patients with designated fluency disorder diagnoses.
Action Required
By January 1, 2026: Speech therapy billing teams in Nevada must update prior authorization workflows to exempt patients under age 26 with stuttering diagnoses (F80.81, F98.5, I69.023, R47.82) from PA requirements for CPT codes 92507, 92508, 92520, 92526, 92605-92609, 97129, 97130, and 97533. Update billing system rules and encounter forms to identify qualifying patients. Continue requiring PA for patients age 26+ or without stuttering diagnoses.