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MedicaidAdministrativeMedium impact

Attention Provider Type 85 (Applied Behavior Analysis (ABA)): Update for Claims with Overlapping Dates of Service

Nevada Medicaid·NV · Psychiatry·Provider Enrollment
Effective date
Jan 1, 2025
We identified it
Jun 21, 2026
Days to comply

Summary

Nevada Medicaid has corrected a system error that was incorrectly denying Applied Behavior Analysis (ABA) provider claims when services overlapped with inpatient psychiatric hospitals or residential treatment centers. ABA providers can now bill for services during these overlapping periods without automatic denials.

Action Required

Action needed
Starting January 1, 2025: ABA providers (Provider Type 85) can resubmit previously denied claims with error codes 5003 or 5004 for overlapping dates of service with psychiatric hospitals or residential treatment centers. Review and resubmit any claims denied since these errors began occurring. No automatic reprocessing will occur - manual resubmission is required.