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Nebraska MedicaidMedicaid · Coverage · Provider Bulletin · NE · Family Medicine, General Practice, Internal MedicineHigh impact

Targeted Case Management Program for Chronic Diseases (TCMP CD) - LB 527

Act
by Mar 31, 2027
Effective date
Jan 1, 2027
Identified
Oct 31, 2026

Summary

Nebraska Medicaid is implementing a new Targeted Case Management Program for Chronic Diseases (TCMP CD) effective January 1, 2027, paying qualified PCMH-certified providers $75 per member per month for managing beneficiaries with diabetes and chronic kidney disease stage 3 or higher. Providers must enroll as a new PCMH provider type by March 31, 2027, and may submit backdated claims for services provided January 1–March 31, 2027, if filed by October 31, 2027.

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What to do

by Mar 31, 2027 · 5 steps
01Billing team must verify that the practice is PCMH-certified by NCQA or Joint Commission for at least one year, then enroll with Maximus under the new PC (Primary Care Medical Home) provider type with specialty 01 (general practice), 08 (family practice), or 11 (internal medicine).
02By October 31, 2027: Submit all backdated CMS-1500 claims with procedure code T1017 UT for TCMP CD services rendered January 1–March 31, 2027, to remain within the six-month filing period.
03Billing team should download and implement required DHHS documentation forms (MLTC-121, MLTC-122, MLTC-125, MLTC-126, MLTC-127) from https://dhhs.ne.gov/Pages/Forms.aspx and ensure clinical staff complete intake assessments, person-centered care plans, and care coordinator checklists for eligible beneficiaries.
04Before November 20, 2026: Providers should attend the Initial Provider Training via Microsoft Teams on November 20, 2026, 10:00–11:00 am to understand program requirements and billing procedures.
05Claims submitted outside the six-month filing window will fall outside the filing period and will not be accepted.

Codes mentioned

T1017

Original notice

Targeted Case Management Program for Chronic Diseases (TCMP CD) - LB 527
dhhs.ne.gov · Always check the source before changing claims.
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Related policy hubs

Nebraska Medicaid policiesNE policy changesFamily MedicineGeneral PracticeInternal MedicineCode T1017

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