MedicaidAdministrativeHigh impact
Attention Provider Type (PT) 17 (Special Clinics) Specialty 188 (Certified Community Behavioral Health Center (CCBHC)): Two Claim Reprocessing Efforts
Nevada Medicaid·NV · Psychiatry·Billing & Coding
Effective date
Sep 6, 2024
We identified it
Jun 21, 2026
Summary
Nevada Medicaid is automatically reprocessing and recouping payments for T1040 claims submitted by Certified Community Behavioral Health Centers (CCBHCs) that were incorrectly paid by Medicaid Fee-for-Service instead of MCOs. Two reprocessing efforts will occur with results appearing on September 6, 2024 and October 25, 2024 remittance advices.
Action Required
By September 6, 2024: CCBHCs must review remittance advice for reprocessed T1040 claims from November 2, 2023 through April 25, 2024. By October 25, 2024: Review remittance advice for reprocessed T1040 claims for MCO-enrolled recipients from July 1, 2022 through June 3, 2024. Billing teams should ensure future T1040 claims for MCO-enrolled recipients are submitted to the appropriate MCO, not Medicaid FFS. Contact NVRecovery@dhcfp.nv.gov for repayment questions.