MedicaidAdministrativeMedium impact
Attention Provider Type (PT) 85 (Applied Behavioral Analysis) and PT 63 (Inpatient Psychiatric Residential Treatment Facility (PRTF)/Residential Treatment Center (RTC)): Addendum to Web Announcement 3380
Nevada Medicaid·NV · Psychiatry·Provider Enrollment
Effective date
Jul 19, 2024
We identified it
Jun 21, 2026
Summary
Nevada Medicaid clarifies that providers can bill for both Psychiatric Residential Treatment Facility (PRTF)/Residential Treatment Center (RTC) services and Applied Behavioral Analysis (ABA) services on the same day, with claim edits bypassed to allow payment. This clarification now explicitly applies to both in-state and out-of-state providers.
Action Required
Immediately: Billing teams for PT 85 (Applied Behavioral Analysis) and PT 63 (PRTF/RTC) providers should verify that Nevada Medicaid claims for same-day PRTF/RTC and ABA services are processing correctly without claim edit rejections. Contact Nevada DHCFP Behavioral Health Benefits and Coverage Unit at BehavioralHealth@dhcfp.nv.gov if experiencing claim denials for these same-day services.