MedicaidAdministrativeMedium impact
Autism Spectrum Disorder (ASD) Diagnosis Certification for Requesting Initial Applied Behavior Analysis (ABA) Services (Form FA-11F) Updated
Nevada Medicaid·NV · Pediatrics, Psychiatry·Provider Announcement
Effective date
Aug 21, 2024
We identified it
Jun 21, 2026
Summary
Nevada Medicaid updated Form FA-11F for ASD diagnosis certification when requesting initial Applied Behavior Analysis (ABA) services, dated 08/21/2024. Providers must immediately stop using the old version and switch to the updated form, though previously completed forms don't need to be redone.
Action Required
Immediately: Download and use the updated Form FA-11F dated 08/21/2024 from Nevada Medicaid website for all new ASD diagnosis certifications for ABA services. Billing team and providers must discontinue using previous versions of the form. Previously completed FA-11F forms do not need to be resubmitted.