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    v1.0.30
    OpenPayerPolicy UpdatesPsychiatry/Behavioral HealthNevada Health Authority BHTC Coverage | OpenPayer
    Ask Trek AI about this page
    ModifiedNevada Health AuthorityPolicy N/A

    Behavioral Health Training Clinic

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    This policy governs the structure, enrollment, documentation, supervision, covered services, authorization, billing, and non-covered services of Behavioral Health Training Clinics serving Nevada Medicaid recipients. It applies to Medicaid-enrolled BHTCs and providers delivering services under the BHTC model, including behavioral health trainees and supervising professionals.

    Policy Summary
    PayerNevada Health Authority
    PolicyBehavioral Health Training Clinic
    Policy CodePolicy N/A
    Change TypeModified
    Effective DateAug 26, 2026
    Next Review DateN/A
    Key ActionObtain prior authorization for non-medical BHTC services after 18 annual adult units or 26 annual child units.
    SourceLink
    POLICY UPDATE CHANGES

    Neuropsychological, psychological, and developmental testing was added to the list of covered non-medical services.

    Individual, group, and family therapy were combined into a single covered non-medical service description.

    Psychotherapy with evaluation and management services was added as a covered medical service.

    Supervision, education, and training provided to behavioral health trainees was added as a non-covered service.

    The chapter was reorganized and its language was edited for grammar, punctuation, capitalization, acronym standardization, duplication removal, clarity, and section renumbering.

    18 unitsAdult annual units before prior authorization
    26 unitsChild annual units before prior authorization

    OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.

    90 daysMaximum prior authorization interval
    2Covered BHTC billing codes
    4Non-covered service categories

    Eligibility and Coverage Requirements

    Member Eligibility

    Eligible members must meet all of the following conditions.

    Eligible member: The member is diagnosed with a behavioral health disorder and has been identified by the BHTC as having a documented need for behavioral health services.

    BHTC and Provider Eligibility

    The BHTC and its personnel must satisfy all applicable organizational and professional requirements.

    Eligible BHTC model: The clinic is operated by a Nevada-accredited university or pursuant to a faculty practice plan to which such a university is a party, and operates under the direction of a licensed physician.
    Eligible trainee: The trainee holds a bachelor's degree, is supervised by a licensed professional, and is either enrolled in an accredited mental or behavioral health graduate program participating in a supervised practicum or internship, or has completed academic requirements and is obtaining legally required supervised practice hours.
    Accreditation and program compliance: The university and degree program must be accredited by the appropriate accrediting body, maintain accreditation, and comply with accreditation standards while enrolled as a BHTC.

    The BHTC benefit does not cover non-evidence-based practices, documentation, transportation, or supervision, education, and training provided to behavioral health trainees. Claims for these services may be denied because they are outside the covered benefit.

    Covered Services and Billing Parameters

    Medical behavioral health servicesHCPCSCovered
    H0037Medical behavioral health services
    Non-medical behavioral health servicesHCPCSCovered
    H2020Non-medical behavioral health services
    Adult Non-Medical Service Units
    ServiceNon-medical BHTC services for adults
    Annual limitUp to 18 units annually
    Prior authorizationRequired after the annual unit limit is reached
    Child Non-Medical Service Units
    ServiceNon-medical BHTC services for children
    Annual limitUp to 26 units annually
    Prior authorization

    Provider Responsibilities and Denial Risks

    Prior Authorization

    Prior Authorization After Annual Unit Threshold

    Obtain prior authorization for BHTC non-medical services after the annual unit threshold is reached. Authorization must be based on the recipient’s documented treatment-plan needs and approved by the Medicaid QIO-like vendor.

    • Adults: up to 18 units annually before prior authorization is required.
    • Children: up to 26 units annually before prior authorization is required.
    • Prior authorizations may not exceed 90-day intervals.
    • Medical services do not require prior authorization.
    Documentation Required

    Maintain the Trainee Contract

    Maintain a contract with each behavioral health trainee and keep it in the trainee’s file. Produce the contract to Nevada Medicaid upon request.

    Policy Background

    A Behavioral Health Training Clinic (BHTC) is a service model operated by a Nevada-accredited university or under a faculty practice plan to which the university is a party, under the direction of a licensed physician. The BHTC delivers behavioral health services to Medicaid recipients while also providing supervision, training, and education to behavioral health trainees. Behavioral health services must be provided under MSM Chapter 400, and trainee supervision, education, and training must relate directly to licensure, certification, or registration requirements.

    Key Terms

    Behavioral Health Training Clinic (BHTC)
    Organizational modelA service model operated by a Nevada-accredited university or pursuant to a faculty practice plan to which such a university is a party
    DirectionOperates under the direction of a licensed physician
    FunctionsProvides behavioral health services to Medicaid recipients and provides supervision, training, and education to behavioral health trainees
    Behavioral Health Trainee
    Professional statusA person seeking licensure, certification, or registration as a behavioral health professional
    Required practiceEngages in supervised practice required to obtain the applicable licensure, certification, or registration

    Covered Behavioral Health Services

    Medical Behavioral Health Services

    Covered when the service meets one of the following descriptions.

    Medical behavioral health service: The service is behavioral health assessment with medical services, psychotherapy with evaluation and management services, or evaluation and management services involving evaluation and management of client behavioral health.

    Medical services may be provided by a trainee seeking a psychiatrist license or by an APRN providing psychiatric services, under the direction of a licensed professional operating within scope of practice.

    Non-medical Behavioral Health Services

    Covered when the service meets one of the following descriptions.

    Non-medical behavioral health service

    • The service is a behavioral health assessment.

      Behavioral health assessments refer to MSM Chapter 400.

    Annual Non-Medical Service Thresholds

    Adult Visit Limit
    PopulationAdults receiving non-medical BHTC services
    Annual thresholdUp to 18 units annually before prior authorization is required
    After thresholdPrior authorization is required
    Child Visit Limit
    PopulationChildren receiving non-medical BHTC services
    Annual thresholdUp to 26 units annually before prior authorization is required
    After thresholdPrior authorization is required
    Policy Summary
    PayerNevada Health Authority
    PolicyBehavioral Health Training Clinic
    Policy CodePolicy N/A
    Change TypeModified
    Effective DateAug 26, 2026
    Next Review DateN/A
    Key ActionObtain prior authorization for non-medical BHTC services after 18 annual adult units or 26 annual child units.
    SourceLink
    On This Page
    Eligibility and Coverage RequirementsCovered Services and Billing ParametersProvider Responsibilities and Denial RisksPolicy BackgroundKey TermsCovered Behavioral Health ServicesAnnual Non-Medical Service Thresholds
    Required after the annual unit limit is reached
    Prior Authorization Interval
    Authorization intervalPrior authorizations may not exceed 90-day intervals
    Approval entityMedicaid's Quality Improvement Organization (QIO)-like vendor
    Authorization basisThe recipient's needs as documented in the treatment plan
    • Assigned supervising licensed professional
    • Supervision requirements
    • Practicum or internship learning activities
    • Professional competencies
    • Program requirements established by the applicable accrediting body, licensing board, or other recognized professional authority
    Documentation Required

    Maintain the Recipient Medical Record

    Maintain the required documentation in each recipient’s medical record in accordance with MSM Chapter 100 and MSM Chapter 400 documentation standards.

    • Behavioral health assessment
    • Individualized treatment plan
    • Progress notes
    • Discharge plan
    • Discharge summary
    Documentation Required

    Document and Provide Supervision

    Assign supervision in accordance with the supervisor’s scope of practice, licensing-board requirements, and the trainee’s discipline. The supervising licensed professional assumes responsibility for the trainee and must provide clinical supervision.

    • Maintain documentation of supervision as required by the applicable licensing board.
    • The supervisor must review and sign the trainee’s documentation.
    Denial Risk

    Non-Covered Services

    The following services are non-covered under this benefit and may be denied when billed as covered services.

    • Non-evidence-based practices
    • Documentation
    • Transportation
    • Supervision, education, and training provided to trainees
    Billing Rule

    Verify Member Eligibility

    Confirm that the member has a behavioral health disorder and a documented need for behavioral health services identified by the behavioral health training clinic (BHTC).

    • Diagnosed behavioral health disorder
    • Documented need for behavioral health services identified by the BHTC
    Denial Risk

    Prevent Incomplete or Unsigned Records

    Keep complete, current records and obtain all required signatures. Missing signatures or supervisory review can create a documentation deficiency and denial risk.

    • All recipient medical-record documents must be signed by both the behavioral health trainee and the assigned supervisor.
    • The supervisor must review and sign the trainee’s documentation.
    • Maintain records according to MSM Chapter 100 and MSM Chapter 400 documentation standards.
    • Maintain supervision documentation as required by the applicable licensing board.
    Qualifying pathwayEither a student in an accredited mental or behavioral health graduate program participating in a supervised practicum or internship, or a person completing legally required supervised practice hours after completing academic requirements
    Faculty Practice Plan
    Program typeA structured program enabling university faculty to engage in clinical practice or consulting work as part of their academic role
    AdministrationAdministered by the university or its affiliated academic medical center
    PurposeSupports faculty clinical practice or consulting within the faculty member's academic role
    The service is neuropsychological, psychological, or developmental testing.
  1. The service is individual, group, or family therapy.