Nebraska Medicaid Program

Provider Information

Personal Assistance Services Provided in Adult Daycare Setting Provider Handbook

The links below comprise your Nebraska Medicaid Provider Handbook. This handbook is your primary resource for information about the Nebraska Medicaid Program, including program regulations, service coverage requirements and limitations, forms, billing requirements, and payment information.

Please review this handbook prior to providing services and requesting payment from Nebraska Medicaid and share it with personnel who perform referrals, authorization, coding and claims submission for your office.

If you have questions or comments about this information, contact the Medicaid Program Specialist for the type of service: PDFContacts.

PDF Regulations

Chapter 1 Administration
Chapter 2 Provider Participation
Chapter 3 Payment for Medical Services
Chapter 15 Personal Assistance Services

PDF Appendices (Forms, Reports and Instructions)

471-000-69 Instructions for Completing Form MS-82, "Adult Day Care Assessment/ Authorization"
471-000-75 Nebraska Medicaid Billing Instructions for Completing Form MC-82-AD, “Adult Day Care Nursing/Aide Services Claim Form” for Private Duty Nursing or Personal Assistance Services in Adult Day Care Centers
471-000-85 Explanation of Remittance Advice and Refund Requests Report
471-000-90 Form MC-19, "Medical Assistance Provider Agreement" and Completion Instructions
471-000-99 Medicaid Claim Adjustment and Refund Procedures
471-000-123 Explanation of Nebraska Medicaid Eligibility Documents
471-000-124 Instructions for Using the Nebraska Medicaid Eligibility System (NMES)
471-000-127 Explanation of Deleted Medicaid Claims Weekly Report (MCP564-D)
471-000-128 Explanation of Medicaid Claims in Process Over 30 Days Report (MCP564-S)
471-000-515 Nebraska Medicaid Personal Assistance Services Rate Listing

PDF Provider Bulletins

Number Subject Date
​14-12 ​Billing Instructions Updated – CMS 1500 and CMS 1450 (UB04) ​03/05/14
​13-50 Timely Filing Requirement for all Medicaid Claims ​07/15/13
​12-09 Initial ICD-10 Awareness ​02/07/12
11-13

UPDATE Nebraska Medicaid Implementation of the National Correct Coding Initiative Edits

02/11/11
10-39

Nebraska Medicaid Implementation of the National Correct Coding Initiative Edits

09/20/10
10-27

Personal Assistance Services Provider Rate Increase.

07/01/10
09-02

Provider responsibility to screen employees and contractors for HHS-OIG exclusion status

02/04/09
08-12

DHHS Website Email Notification Feature, Online Provider Handbooks and Provider Bulletins, Electronic Claims, Funds Transfer and Other Options

05/12/08
07-10

New Medicaid Claim Reports – New Process for Reporting Deleted Medicaid Claims

05/09/07

Go to Rules and Regulations and Provider Bulletins for all Medicaid regulations, appendices and bulletins.

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