Nevada Medicaid Hearing on Changes Affecting Crisis Services

Nevada Medicaid will hold a public hearing on September 30, 2025, on many topics affecting behavioral health crisis services and other behavioral health services. Topics include:

Crisis Services (Crisis Intervention, Mobile Crisis, and Crisis Stabilization services) - Creation of Medicaid Services Manual (MSM) Chapter 4400 – Crisis Services are being proposed. The following crisis services are being removed from Chapter 400 and being moved with revisions and updates to the new MSM Chapter 4400: Crisis Intervention (CI), Designated Mobile Crisis Team (DMCT), and Crisis Stabilization Center (CSC).  Additionally, MSM 4400 will include new community-based crisis services: Mobile Crisis Team (MCT) and Intensive Crisis Stabilization Service (ICSS) facility. These changes are effective October 1, 2025.

Assertive Community Treatment (ACT) - Proposed revisions to Medicaid Services Manual (MSM) Chapter 400 - Mental Health Services include the addition of Assertive Community Treatment (ACT) for individuals with serious and persistent mental illness. ACT is a team-based, community-focused treatment approach that provides comprehensive psychiatric treatment, rehabilitation, and support. Its goal is to improve functioning and help individuals remain in their communities, avoiding inpatient treatment.

During the 83rd Legislative Session (2025), the DHCFP budget was approved through Senate Bill 501 and included the addition of ACT. The Nevada Health Authority is proposing a Medicaid State Plan Amendment (SPA) to add Assertive Community Treatment (ACT). The Division intends to develop a bundled rate that reflects the core services delivered in this model, including screening and assessment, psychotherapy, family education and support, case management, medication management and supported employment and supported education services. These proposed changes are being made to Attachment 4.19-B and Attachment 3.1-A, with an effective date of July 1, 2025.

First Episode Psychosis (FEP) – Revisions to Medicaid Services Manual (MSM) Chapter 400 - Mental Health Services are being proposed to add Coordinated Specialty Care for beneficiaries experiencing their first episode of psychosis. Coordinated specialty care (CSC) is the standard of care for treatment for individuals, typically in late adolescence to mid-20s experiencing their first episode of psychosis (FEP).  It is an evidence-based, recovery-focused, team-based early intervention model that promotes access to care and shared decision-making among specialists, the person experiencing psychosis, and family member.  

During the 83rd Legislative Session (2025), the DHCFP budget was approved through Senate Bill 501 and included the addition of services for First Episode Psychosis (FEP). The Nevada Health Authority is proposing a Medicaid State Plan Amendment (SPA) to add Coordinated Specialty Care for beneficiaries experiencing their first episode of psychosis. Coordinated specialty care (CSC) is the standard of care for treatment for individuals, typically in late adolescence to mid-20s, experiencing their first episode of psychosis (FEP). The Division intends to develop a bundled rate that reflects the core services delivered in this model, including screening and assessment, psychotherapy, family education and support, case management, medication management and supported employment and supported education services. These proposed changes are being made to Attachment 4.19-B and Attachment 3.1-A, with an effective date of July 1, 2025.

Mental Health Services - Revisions to Medicaid Services Manual (MSM) Chapter 400 – Mental Health Services are being proposed to remove “face-to-face” references, remove Neurotherapy service limitations based on diagnostic codes, remove section 403.5(C) including the Intensity of Services Grid, remove the exclusion of independent psychologists and psychiatrists from the service limitations, add a standard session limit of 26 sessions for individual, group, or family therapy (including neurotherapy) for youth, add a standard session limit of 18 sessions for individual, group, or family therapy (including neurotherapy) for adults, add the language “Licensed professional, Certified Professional, or QMHP” where appropriate throughout MSM 400, and restructure the Assessments section including: adding eligible providers, separating Comprehensive Assessment and Health and Behavior Assessment into two distinct definitions, adding authorization requirements, and adding billing information. Effective date: July 1, 2025.

The agenda and supporting materials, including information on how to join the meeting, are available on the Nevada Division of Health Care Financing and Policy (DHCFP) website at https://dhcfp.nv.gov/Public/AdminSupport/PublicNotices/.