ABA insurance and Medicaid coverage in Nevada
Last researched October 21, 2026
Who pays for ABA in Nevada, and what a practice has to do to bill them. Coverage details here come from statutes and agency pages we read, not from payer marketing.
Autism insurance mandate
- State mandate for autism coverage
Yes, the research found a state autism coverage law.
- Statute
NRS 689B.0335 (group health insurance: required); NRS 689C.1655 (small-employer health insurance: required); NRS 689A.0435 (individual health insurance: insurer must provide an OPTION of coverage); NCSL also lists NRS 287.0276
- Age limits
Under 18, or until age 22 if enrolled in high school (NRS 689B.0335(1), NRS 689A.0435(1); the same ages are confirmed in the small-employer statute, NRS 689C).
- Annual cap
Maximum benefit of the actuarial equivalent of $72,000 per year for ABA treatment (group: 'subject to'; individual: 'not less than'; small-employer coverage uses the same statutory ABA amount). Per the checker, the autism provision's subsection 4 prohibits visit limits subject to subsections 1-2.
- Excludes self-funded employer plans
We could not verify this yet - check with your state insurance department.
- Notes
As of 2026-10-21, per the Nevada Legislature site text: NRS 689B.0335 says a group policy delivered, issued or renewed on or after Jan 1, 2026 has the legal effect of including the coverage (subsection 6). Group and small-employer (NRS 689C.1655) insurers 'must provide coverage'; individual-market insurers (NRS 689A.0435) 'must provide an option of coverage', so coverage there is optional rather than mandatory. Under current NRS 689A.0435(5) and 689B.0335(5), treatment must be in a treatment plan and be prescribed and delivered by a health-care provider acting within the scope of their license/practice. The narrower physician/psychologist/licensed-behavior-analyst-or-supervisee wording appears on the outdated Public.Law copy and should not be relied on. The cited autism provisions do not establish a comprehensive self-funded-plan exclusion, so that field is left null. The self-insured-employer replacement provision and the Public Employees Benefits Program exclusion belong to NRS 689B.065(4), not NRS 689B.0335(4), and are not part of this section's autism provisions.
Medicaid ABA coverage
- Medicaid covers ABA
Yes, per the sources below.
- Program
Nevada Medicaid ABA (Medicaid Services Manual Chapter 3700; provider type 85)
- Agency
Nevada Medicaid, Medicaid Division of the Nevada Health Authority; fiscal agent Gainwell Technologies
- Provider enrollment
- https://www.medicaid.nv.gov/providers/enroll
Payers named in our research
Names come from the research behind this page. Appearing here does not mean a payer is accepting new providers or that networks are open. Always confirm directly with the payer.
Medicaid managed care plans
- CareSource Nevada (Medicaid) - CareSource publishes Nevada Medicaid ABA reimbursement policy NV MCD-PY-1695 effective 2026-01-01. Other Nevada Medicaid MCOs were not verified.
Other payers
- Nevada Medicaid (fee-for-service, PT 85) - State fee-for-service program run by DHCFP/Gainwell.
How to enroll
- Start at the state Medicaid provider enrollment page: https://www.medicaid.nv.gov/providers/enroll.
- Ask each commercial payer you want to bill for its credentialing application and timeline. We have not verified payer timelines.
- Confirm which staff types the payer reimburses, including whether technicians must hold the RBT credential. See BT vs RBT in Nevada.
Related guides for Nevada
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