Nebraska Administrative Code

TITLE 470 - REFUGEE RESETTLEMENT PROGRAM AND MEDICAL ASSISTANCE PROGRAM CHAPTER 4 - REFUGEE MEDICAL ASSISTANCE PROGRAM 001. REFUGEE MEDICAL ASSISTANCE PROGRAM. The Refugee Medical Assistance Program provides medical care and services to refugees who: (A) Are eligible for Refugee …

TITLE 471 NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 1 ADMINISTRATION 001. SCOPE AND AUTHORITY. The regulations govern the services provided under Nebraska’s Medicaid program as defined by Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68‑901 to 68‑991. 002. NEBRASKA MED…

TITLE 471 NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 10 HOSPITAL SERVICES 001. SCOPE AND AUTHORITY. These regulations govern the services provided under Nebraska’s Medicaid program as defined by the Medical Assistance Act, Nebraska Revised Statute (Neb. Rev. Stat.) §§ 6…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 11-000 - INDIAN HEALTH SERVICE (IHS) FACILITIES 11-001 Definitions Encounter: A face-to-face visit, including telehealth services provided in accordance with 471 NAC 1-006, between a health care professional and an …

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 12 - NURSING FACILITY REGULATIONS 001. SCOPE AND AUTHORITY. The regulations govern the services provided under Nebraska’s Medicaid program as defined by Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68-901 et seq. (…

TITLE 471 NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 14 OCCUPATIONAL AND PHYSICAL THERAPY SERVICES 001. SCOPE AND AUTHORITY. These regulations govern the services provided under Nebraska’s Medicaid program as defined by Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68‑9…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 15 - PERSONAL ASSISTANCE SERVICES 001. SCOPE AND AUTHORITY. Medicaid personal assistance services are defined in federal regulations at 42 Code of Federal Regulations (CFR) 440.167, and are an optional Medicaid bene…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 16 - PHARMACY SERVICES 001. SCOPE AND AUTHORITY. The regulations govern the services provided under Nebraska’s Medicaid program as defined by the Medical Assistance Act (Nebraska Revised Statute §§ 68-901 et seq). 0…

TITLE 471 NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 18 PHYSICIANS' SERVICES 001. SCOPE AND AUTHORITY. These regulations govern the services provided under Nebraska’s Medicaid program as defined by Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68-901 et seq. 002. DEFINI…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 19 - PODIATRY SERVICES 001. SCOPE AND AUTHORITY. The regulations govern the services provided under Nebraska’s Medicaid program as defined by Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68-901 et seq. 002. DEFINIT…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 2 - PROVIDER PARTICIPATION 001. SCOPE AND AUTHORITY. These regulations govern services provided under the Medical Assistance Act, Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68-901 to 68-991. 002. DEFINITIONS. The…

TITLE 471 NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 20 PSYCHIATRIC SERVICES FOR BENEFICIARIES AGE 21 AND OLDER 001. SCOPE AND AUTHORITY. These regulations govern services provided under the Medical Assistance Act, Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68-901 et…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 21-000 - REHABILITATION CARE IN HOSPITALS 21-001 Definitions Activities of Daily Living: Activities performed by the client relating to self-care, such as bathing, continence, eating, dressing, grooming, mobility, t…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 22 - RESPIRATORY THERAPY SERVICES 001. SCOPE AND AUTHORITY. The regulations govern the services provided under Nebraska’s Medicaid program as defined by Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68-901 et seq. 0…

TITLE 471 NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 23 SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY SERVICES 001. SCOPE AND AUTHORITY. These regulations govern the services provided under Nebraska’s Medicaid program as defined by Nebraska Revised Statute (Neb. Rev. Stat.) §…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 24 - VISUAL CARE SERVICES 001. SCOPE AND AUTHORITY. The regulations govern the services provided under Nebraska’s Medicaid program as defined by Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68-901 et seq. 002. DEFI…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 25 - SCHOOL-BASED SERVICES 001. SCOPE AND AUTHORITY. These regulations govern services provided in schools under the Medical Assistance Act, Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68-901 to 68-991, and Neb. R…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 26-000 - AMBULATORY SURGICAL CENTER (ASC) SERVICES 26-001 Standards for Participation: NMAP covers facility services provided by ambulatory surgical centers in connection with certain surgical procedures. To partici…

TITLE 471 NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 27 NON-EMERGENCY MEDICAL TRANSPORTATION (NEMT) SERVICES 001. SCOPE AND AUTHORITY. The regulations govern the services provided under Nebraska’s Medicaid program as defined by Nebraska Revised Statute §§ 68-901 et seq.…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES Chapter 28-000 - PRESUMPTIVE ELIGIBILITY 28-001 Presumptive Eligibility for Pregnant Women: Under Section 1920 of the Social Security Act, Medicaid covers ambulatory prenatal care provided by an enrolled Medicaid provider t…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 29-000 - FEDERALLY-QUALIFIED HEALTH CENTERS (FQHC'S) 29-001 Standards for Participation: To be considered a Federally-Qualified Health Center (FQHC) for the Nebraska Medical Assistance Program, as allowed by section…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 3 - PAYMENT FOR MEDICAID SERVICES 001. SCOPE AND AUTHORITY. The regulations govern the services provided under Nebraska’s Medicaid program as defined by the Medical Assistance Act (Nebraska Revised Statute § 68-901 …

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 30 - HEALTH INSURANCE PREMIUM PAYMENT PROGRAM 001. SCOPE AND AUTHORITY. The regulations govern the services provided under Nebraska’s Medicaid program as defined by Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68-9…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 31 - SERVICES IN AN INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES (ICF/DD) 001. SCOPE AND AUTHORITY. The regulations govern the services provided under Nebraska’s Medicaid program as def…

TITLE 471 NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 32 CHILDREN’S MENTAL HEALTH AND SUBSTANCE USE DISORDER TREATMENT SERVICES 2. 001. SCOPE AND AUTHORITY. These regulations govern services provided under the Medical Assistance Act, Nebraska Revised Statute (Neb. Rev. S…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 33 - HEALTH CHECK (EARLY PERIODIC SCREENING, DIAGNOSIS AND TREATMENT [EPSDT]) SERVICES 001. SCOPE AND AUTHORITY. The regulations govern the services provided under Nebraska’s Medicaid program as defined by Nebraska …

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 34-000 - RURAL HEALTH CLINICS (RHC's) 34-001 Standards for Participation: To participate in the Nebraska Medical Assistance Program (NMAP), a Rural Health Clinic must be certified by the Centers for Medicare and Med…

TITLE 471 NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 35 REHABILITATIVE PSYCHIATRIC SERVICES 001. SCOPE AND AUTHORITY. These regulations govern services provided under the Medical Assistance Act, Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68-901-68-9,101. 001.01 INTRO…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 36 - HOSPICE SERVICES 001. SCOPE AND AUTHORITY. These regulations govern services provided under the Medical Assistance Act, Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68-901 et seq. 002. DEFINITIONS. The followi…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 37-000 - PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY 37-001 INTRODUCTION: This chapter regulates Nebraska’s Program of All-Inclusive Care for the Elderly (PACE) provided under Nebraska Medicaid. 37-001.01 Definiti…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 38 - ESTATE RECOVERY 001. SCOPE AND AUTHORITY. Medicaid estate recovery is mandated by §1917(b) of the Social Security Act and Nebraska Revised Statute (Neb. Rev. Stat.) §68-919. 002. RESERVED. 003. RESERVED. 004. U…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 39 - NEBRASKA ALTERNATIVE BENEFIT PLAN (ABP) 001. SCOPE AND AUTHORITY. The regulations govern the services provided under Nebraska’s Medicaid program as defined by Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68-90…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 4 - AMBULANCE SERVICES 001. SCOPE AND AUTHORITY. These regulations govern services provided under the Medical Assistance Act, Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68-901 et seq. 002. DEFINITIONS. The follow…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 42-000 - FREESTANDING BIRTH CENTERS 42-001 STANDARDS FOR PARTICIPATION: Medicaid covers facility services provided by non-hospital freestanding birth centers. To participate in Medicaid, a freestanding birth center …

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 43 - NURSING FACILITY LEVEL OF CARE DETERMINATION FOR CHILDREN 001. SCOPE AND AUTHORITY. The regulations govern the services provided under Nebraska’s Medicaid program as defined by Nebraska Revised Statute (Neb. Re…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 44 - NURSING FACILITY LEVEL OF CARE DETERMINATION FOR ADULTS 001. SCOPE AND AUTHORITY. The regulations govern the services provided under Nebraska’s Medicaid program as defined by Nebraska Revised Statute (Neb. Rev.…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 45 - RATES FOR NURSING FACILITY SERVICES 001. SCOPE AND AUTHORITY. The regulations govern the services provided under Nebraska’s Medicaid program as defined by Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68-901 et…

001. SCOPE AND AUTHORITY. These regulations govern the services provided under Nebraska’s Medicaid program as defined by the Medical Assistance Act, Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68-901 et seq. 002. DEFINITIONS. The following definitions apply: 002.01 ALLOWABLE CO…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 47 - TELEHEALTH 001. SCOPE AND AUTHORITY. The regulations govern the services provided under Nebraska’s Medicaid program as defined by Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68-901 et seq. 002. DEFINITIONS. T…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 5 - CHIROPRACTIC SERVICES 001. SCOPE AND AUTHORITY. These regulations govern services provided under the Medical Assistance Act, Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68-901 et seq. 002. PROVIDER REQUIREMENT…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 6 - DENTAL SERVICES 001. SCOPE AND AUTHORITY. These regulations govern services provided under the Medical Assistance Act, Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68-901 et seq. 002. DEFINITIONS. The following…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 7 - DURABLE MEDICAL EQUIPMENT, PROSTHETICS, ORTHOTICS, AND MEDICAL SUPPLIES (DMEPOS) 001. SCOPE AND AUTHORITY. These regulations govern services provided under the Medical Assistance Act, Nebraska Revised Statute (N…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 8 - HEARING AIDS 001. SCOPE AND AUTHORITY. These regulations govern services provided under the Medical Assistance Act, Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68-901 et seq. 002. DEFINITIONS. The following de…

TITLE 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES CHAPTER 9 - HOME HEALTH AGENCIES AND SKILLED NURSING SERVICES 001. SCOPE AND AUTHORITY. These regulations govern services provided under the Medical Assistance Act, Nebraska Revised Statute (Neb. Rev. Stat.) §§ 68-901 et se…

TITLE 472 DISABLED PERSONS AND FAMILY SUPPORT PROGRAM CHAPTER 1 INTRODUCTION 001. SCOPE AND AUTHORITY. This title governs the administration of the Disabled Persons and Family Support Program, Nebraska Revised Statutes (Neb. Rev. Stat.) §§ 68-1501 through 1519. 002. DEFINITIONS. …