MedicaidCoverageMedium impact
Attention Provider Type 85 (Applied Behavior Analysis): Error Code 5735 Updated
Nevada Medicaid·NV · Psychiatry·Provider Enrollment
Effective date
Dec 21, 2025
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has removed the 40-hour per week service limit for Applied Behavior Analysis (ABA) providers effective December 21, 2025. Error code 5735 (Limit of Forty Hours per Week PA Override) no longer applies to procedure codes 0362T, 97151, and 97152.
Action Required
Immediately: ABA providers (Provider Type 85) should update billing procedures to remove the 40-hour weekly service limit for codes 0362T, 97151, and 97152. Review the PT 85 Billing Guide for current prior authorization requirements. No automatic claim reprocessing will occur for past claims.