MedicaidBilling CodesMedium impact
Provider Type (PT) 12 (Hospital, Outpatient) and PT 11 (Hospital, Inpatient) Billing Guidelines Updated
Nevada Medicaid·NV · Psychiatry, Emergency Medicine·Billing & Coding
Effective date
Aug 27, 2025
We identified it
Jun 21, 2026
Summary
Nevada Medicaid now allows psychiatric assessments performed in hospital emergency departments by outside entities (not hospital staff) to be billed separately when they lead to inpatient psychiatric admissions. This creates a new billing opportunity for independent psychiatric providers performing assessments in hospital EDs.
Action Required
By August 27, 2025: Billing teams at psychiatric practices that perform assessments in hospital emergency departments must verify they can bill separately for these services to Nevada Medicaid when the assessment leads to inpatient admission. Update billing procedures to distinguish between hospital-staffed vs. outside entity assessments. Review PT 12 and PT 11 Billing Guidelines on Nevada Medicaid's website for specific billing requirements.