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MedicaidAdministrativeMedium impact

Applied Behavioral Analysis Coverage in a Psychiatric Residential Treatment Facility/Residential Treatment Facility

Nevada Medicaid·NV · Psychiatry, Pediatrics·Provider Announcement
Effective date
Jun 20, 2024
We identified it
Jun 21, 2026
Days to comply

Summary

Nevada Medicaid has resolved billing system barriers that were preventing payment for ABA services provided in psychiatric residential treatment facilities (PRTF) and residential treatment facilities (RTC). The state has implemented immediate fixes to allow same-day billing for PRTF/RTC services and ABA services for children with autism spectrum disorder and related conditions.

Action Required

Action needed
Immediately: ABA providers working with Nevada DCFS PRTF/RTC locations should contact Serene Pack at s.pack@dhcfp.nv.gov for instructions on adjusting claims for payment of services within PRTF/RTC facilities. Ensure proper provider enrollment status - PRTF/RTC facilities must be enrolled as ABA providers to bill ABA services separately when employing or contracting with ABA providers directly.