← Back to list
Attention Provider Types 14 (Behavioral Health Outpatient Treatment) and 26 (Psychologist): Procedure Code H0038 Closed for Billing Effective February 26, 2027
Act
by Feb 26, 2027
Effective date
Feb 26, 2027
Identified
Aug 26, 2026
Summary
Effective February 26, 2027, Nevada Medicaid is closing procedure code H0038 (Self-help/peer services) for billing by Provider Types 14 (Behavioral Health Outpatient Treatment) and 26 (Psychologist). Only providers enrolled as PT 97 (Peer Support Specialist) or PT 93/706 (Peer Recovery Support Specialist) may bill H0038 going forward. Peer support specialists can still link to PT 14 and PT 26 groups.
Get alerts when payers change rules like this one
We check Nevada Medicaid and other payers every day and email you when a change matches your specialty and state.
Get Nevada Medicaid alertsPolicy Monitoring is free. No card required.
What to do
by Feb 26, 2027 · 6 steps
01Billing team must implement restrictions in Nevada Medicaid billing system to block H0038 claims submitted by Provider Types 14 and 26 as rendering providers.
02Audit current claims to identify any H0038 billings by PT 14 and PT 26 providers and prepare corrective actions.
03Providers must be notified that H0038 can only be billed if they are enrolled as PT 97 or PT 93/706.
04Update encounter forms and billing workflows to route H0038 claims only through eligible peer support provider types.
05Contact BehavioralHealth@nvha.nv.gov with questions.
06Claims submitted by non-eligible provider types after the effective date will be denied.
Codes mentioned
H0038
Original notice
Attention Provider Types 14 (Behavioral Health Outpatient Treatment) and 26 (Psychologist): Procedure Code H0038 Closed for Billing Effective February 26, 2027
medicaid.nv.gov · Always check the source before changing claims.
Related changes
See all Nevada Medicaid changes →Attention Provider Types 14 (Behavioral Health Outpatient Treatment) and 82 (Behavioral Health Rehabilitative Treatment): Prior Authorization Requirement Updated for Procedure Code H0038MediumEffective Feb 26, 2025 · Prior AuthorizationAttention Provider Types 14 (Behavioral Health Outpatient Treatment), 82 (Behavioral Health Rehabilitative Treatment) and 93 (Substance Use Treatment) Linked to a Provider Type 93 Group: Behavioral Health Services Codes Open For BillingHighEffective Jul 1, 2024 · Billing & CodingAttention Behavioral Health Outpatient Providers: Rate Updates Effective January 1, 2025HighEffective Jan 1, 2025 · ReimbursementAttention Behavioral Health and Peer Support Service Providers: Service Limitation for Procedure Code H0038 Has Been UpdatedMediumEffective Feb 25, 2026 · Provider AnnouncementBrowse every Nevada Medicaid change in the policy list