MedicaidCoverageHigh impact
Attention Provider Types 20 (Physician, M.D., Osteopath, D.O.), 24 (Advanced Practice Registered Nurses), 26 (Psychologist), and 77 (Physician’s Assistant): Claims for Procedure Code S9480 Will Be Reprocessed
Nevada Medicaid·NV · Psychiatry·Provider Announcement
Effective date
Oct 1, 2025
We identified it
Aug 25, 2026
Summary
Nevada Medicaid has retroactively expanded eligibility for procedure code S9480 (Intensive Outpatient Psychiatric Services, Per Diem) to four provider types (Physicians, APRNs, Psychologists, and Physician's Assistants) back to October 1, 2025. Claims submitted between October 1, 2025 and February 8, 2026 by these providers will be automatically reprocessed if they have approved prior authorization; providers should expect potential denials due to system edits and have appeal rights.
Action Required
Immediately: Billing team should monitor for automatic reprocessing of S9480 claims from October 1, 2025 through February 8, 2026 for provider types 20 (MD/DO), 24 (APRN), 26 (Psychologist), and 77 (PA). Verify that all reprocessed claims had approved prior authorization before the service date—only claims with approved PA will be adjudicated. Prepare to receive potential denials on reprocessed claims due to system and clinical edits; document all denials and prepare appeals as needed. Update internal records and billing software to recognize S9480 as billable by these four provider types going forward. Advise affected providers (psychiatrists, psychologists, APRNs, and PAs) to monitor accounts receivable for reprocessed claim activity and expected payment adjustments. Reference Nevada Medicaid Services Manual Chapter 100 and Billing Manual for appeal procedures and timelines.