MedicaidCoverageHigh impact
Attention Provider Type 14 (Behavioral Health Outpatient Treatment): Error Codes 5649, 5690 and 5691 Updated
Nevada Medicaid·NV · Psychiatry·Provider Enrollment
Effective date
Nov 18, 2024
We identified it
Jun 21, 2026
Summary
Nevada Medicaid now limits specific behavioral health procedure codes to one unit per day effective November 18, 2024, with claims exceeding this limit receiving error code 5649. Additionally, procedure code 90839 (crisis psychotherapy) no longer has session limits or prior authorization override requirements.
Action Required
Immediately: Billing team must update Nevada Medicaid billing rules to enforce one unit per day limit for CPT codes 90837, 90845, 90846, 90847, 90849, 90853, 90875, 90876, 90833, 90836, and 90838. Remove session limit restrictions and prior authorization requirements for CPT 90839. Update scheduling system to prevent multiple bookings of limited codes on same day. Claims exceeding limits will be denied with error code 5649.