MedicaidPrior AuthMedium impact
Attention Provider Type 34 (Therapy) Specialties 29 (Speech Pathologist) and 219 (Speech Pathologist Language): Prior Authorization Requirements Removed for Certain Speech Therapy Services Effective January 1, 2026
Nevada Medicaid·NV · Speech Therapy·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 21, 2026
Summary
Nevada Medicaid is removing prior authorization requirements for certain speech therapy services effective January 1, 2026, but only for patients under age 26 with specific stutter diagnoses. Prior authorization will still be required for patients age 26 and older or without qualifying stutter diagnoses.
Action Required
By January 1, 2026: Speech therapy billing team must update prior authorization workflows in billing system to exempt patients under age 26 with stutter diagnoses (F80.81, F98.5, I69.023, R47.82) from PA requirements for the specified CPT codes. Update encounter forms and billing software rules to automatically check patient age and diagnosis before requiring prior authorization. Continue requiring PA for patients age 26+ or without qualifying stutter diagnoses.