MedicaidCoverageHigh impact
Attention Provider Types 34 (Therapy) and 85 (Applied Behavior Analysis): Some Procedure Codes Billed with Place of Service Code 10 Now Deny With Error Code 679
Nevada Medicaid·NV · Physical Therapy, Occupational Therapy, Speech Therapy +1 more·Provider Announcement
Effective date
Sep 23, 2024
We identified it
Jun 21, 2026
Summary
Effective September 23, 2024, Nevada Medicaid will deny specific therapy and Applied Behavior Analysis procedure codes when billed with Place of Service code 10 (telehealth), returning error code 679. This affects 22 therapy codes and 5 ABA codes that are no longer covered under telehealth for provider types 34 and 85.
Action Required
Immediately: Billing team must update system to prevent billing the listed procedure codes with Place of Service code 10 for Nevada Medicaid claims. Use appropriate in-person place of service codes instead (11, 12, 22, etc.) for these procedures. Update billing software rules to flag these code combinations to prevent denials with error code 679.