Nebraska

Nebraska Behavioral Health Credentialing and Payer Enrollment

Q: Do you need my CAQH password?

No, and we will not ask. We are added as an authorized practice manager, which lets us keep your practice data current and authorize payers. You complete and attest your own profile and you sign anything that needs a signature. Nebraska has no state-designated credentialing database, so CAQH is the base layer that the commercial carriers pull from, and the Verisys arrangement on the Medicaid side sits alongside it rather than replacing it. One Nebraska-specific thing to get right early: Blue Cross and Blue Shield of Nebraska runs separate application tracks for new practitioners, provisional providers, delegated and PHO-affiliated providers and facilities, and starting on the wrong track costs weeks.

Two thirds of Nebraskans with employer coverage sit in a self-funded plan, and self-funded employers here lease their network. Which means the contract that reaches most working Nebraskans is a regional PPO out of Omaha that almost no credentialing checklist mentions. Nebraska also has no clock on a carrier’s decision and nothing that pays you for the wait, so the filing order matters more than usual. Here is how the state actually pays, on both tracks.

See what we need from you
Nebraska payers and timelines

What shapes a Nebraska panel

A rental network you can’t skip, and no cushion on either side of the wait.

Nebraska is compact and unusually standardized, which is good news. What it does not give you is time, so where you file and in what order is the whole strategy.

Two thirds of employer coverage is self-funded

And Midlands Choice is what those employers lease

The Department of Insurance reports 66.8 percent of Nebraskans in employment-based plans were in a self-insured plan in 2023, and says its own jurisdiction over those plans is limited
Midlands Choice is the Omaha regional PPO those plans rent, owned by three of the largest health systems in Nebraska and Iowa, with roughly 40 payer partners and close to 300,000 covered lives
It names Cigna, Medica, Oscar Health and HealthPartners on its payer resources page, so one contract can be the practical door to several carriers’ members at once
It credentials advanced nurse practitioners and master’s level behavioral health clinicians, so a psychiatric prescriber is eligible rather than an exception

A card with an employer or administrator name on it may still route through Midlands Choice

One verification, three Medicaid plans

Verisys, since January 1, 2025

All three Heritage Health plans use the same primary source verification vendor, which is rare and it works in your favor
Licensure, board certification, education and adverse action checks get done once instead of three times
It does not merge the contracts. You still sign three agreements and get three separate effective dates
And it does not replace CAQH. Keep that attested as the base layer, because the commercial carriers still pull from it

No clock, no back pay, and retro dates are rarely given

Neb. Rev. Stat. 44-7001 to 44-7013

The Credentialing Verification Act sets real process duties: written policies, verification before contracting, a credentialing committee of licensed clinicians, and your right to review and correct what a carrier gathered about you
What it does not set is a decision deadline, and it does not require anyone to pay you for work delivered while you waited
Iowa next door does both under Iowa Code 514F.6. You can hear the difference in a payer’s own words: Midlands Choice does not backdate except as required by law for Iowa and South Dakota physicians. Nebraska is not on that list
On the Medicaid side the state’s enrollment vendor says retroactive dates for mental health providers are rarely considered, and anything 180 days or more back is a formal request needing a written explanation and DHHS approval

What Nebraska does protect is speed after you’re in

The Prompt Payment Act, Neb. Rev. Stat. 44-8001 to 44-8010

A clean claim has to be paid, denied or settled within 30 calendar days if you filed it electronically, 45 otherwise
If the insurer needs more information it has to tell you in writing within 30 days, and the clock is tolled until you send it
Limit one: an insurer that files a valid compliance statement with the Department of Insurance by December 1 each year is exempt from paying interest on late clean claims. The Department publishes who filed
Limit two: the Act does not reach self-insured plans or Medicaid. In a state where two thirds of employer coverage is self-funded, that is a large hole in the middle of the protection

Where the delays actually happen

Getting on a panel isn’t the same as getting paid.

Most of the waiting happens in the gaps between these five steps. We work all of them, and we tell you which one you’re actually sitting in.

Credentialed›contracted›loaded›connected›payable

Two tracks

Medicaid and commercial work differently here.

Nebraska’s Medicaid side is three statewide plans with one shared verification step. The commercial side is one dominant Blue plan plus a rental network that quietly does a lot of work.

Heritage Health

Three plans. All statewide. State first.

Heritage Health folded physical health, behavioral health and pharmacy into the same managed care plans when it launched on January 1, 2017, replacing the Magellan behavioral carve-out that ran before it. Dental joined the integrated contracts on January 1, 2024. So for a behavioral health prescriber there is no separate behavioral payer to chase: the patient’s plan is the payer. Nebraska Total Care, Molina Healthcare of Nebraska and UnitedHealthcare Community Plan each serve every Medicaid and CHIP member statewide, so there is no regional puzzle and most practices take all three.

How you enrollThrough the Provider Data Management System, the Maximus portal DHHS uses for screening and enrollment. Paper applications ended June 1, 2025, so anything telling you to mail a packet is out of date. Maximus screens the file, DHHS gives final approval.

The mismatch that quietly costs moneyYour PDMS record and your record at each plan have to agree on practice locations, NPIs, tax ID and taxonomy. Molina says it plainly: the state-assigned Medicaid identifier, address and NPI on file with the plan must match what DHHS has, or the claim does not pay. We reconcile those before we submit rather than after a denial.

Forms you’ll actually see

PDMS online enrollmentMLTC-30 disenrollmentCFS-5 registry checkFingerprint background packet

Every location, every timeNebraska requires every business location where services are rendered to be enrolled, and each enrollment carries a single NPI. A second office is a second enrollment, not an address change.

Revalidation, and what breaks if you miss itFive-year federal cycle inside PDMS. Maximus sends notices monthly starting 180 days out, six in all. Miss the date and the provider agreement closes, which means starting over and living with a gap. Two knock-on effects: a closed agreement can break the electronic trading partner agreement you submit claims with, and prescription claims are rejected while the prescriber is inactive.

Commercial

One Blue plan, one rental network, five carriers on the exchange.

Blue Cross and Blue Shield of Nebraska holds both the Blue Cross and the Blue Shield licence here, so reaching the in-state Blue population takes one contract rather than two. It also carries a large book of administrative work for self-funded Nebraska employers, which is where most of the state’s employer coverage actually sits. The 2026 individual market has five carriers and BCBSNE is the only one offering a PPO.

Your CAQH stays yoursYou complete and attest your own profile. We’re added as an authorized practice manager, so we keep the practice data current and get each payer authorized. We never ask for your password. Nebraska has no state-designated credentialing database and no mandated uniform form, so CAQH is the base layer every commercial carrier pulls from.

Pick the right BCBSNE track firstBlue Cross and Blue Shield of Nebraska runs separate application tracks for new practitioners, provisional providers, delegated and PHO-affiliated providers, and facilities. Starting on the wrong one costs weeks before anyone notices. After approval, eligibility, benefits and claims work runs through NaviNet, and the directory reflects status changes on roughly a 24-hour cycle.

Behavioral health has its own doorUnitedHealthcare goes through Optum and Provider Express. Cigna goes through Evernorth. Aetna keeps it in house but uses a separate behavioral health request for participation. BCBSNE and all three Heritage Health plans handle behavioral health inside the plan. Applying at the medical door is the most expensive mistake in a Nebraska credentialing run.

Ask who’s renting the networkNebraska’s network-leasing transparency law, Neb. Rev. Stat. 44-7,110, applies to dental plans only. On the medical side you have no statutory right to a list of who has been granted access to a network you joined, and no opt-out. So we ask during contracting instead of finding out from a remittance.

Seeing patients in other statesAetna, Cigna and UnitedHealthcare are national networks. One BCBSNE contract reaches Blue members who live in other states through BlueCard. What you need is a licence where the patient is sitting, not another contract. Medicaid is the genuine exception, and out-of-state Medicaid does not travel.

Nebraska commercial payers

Who you’ll apply to, and how long it usually takes.

These are typical ranges from a complete application. No Nebraska statute puts a deadline on any of them, so we track the dates and push rather than promise them.

Blue Cross and Blue Shield of Nebraska

The anchor contract

Usually: 60 to 120 days from a complete application. BCBSNE publishes a credentialing timeline resource but does not commit to a fixed turnaround, and no state law imposes one
Path: CAQH complete, attested and BCBSNE authorized, on the right one of its four application tracks
Why it’s first: it holds both Blue licences here, carried about 22,700 individual-market members in 2025, and administers a large share of self-funded Nebraska employer coverage
Behavioral health: handled inside the plan, no carve-out vendor
Reach: one contract plus your out-of-state licences reaches Blue members in other states through BlueCard

Midlands Choice

The contract people forget until a claim shows up

Usually: Midlands Choice says credentialing can take from several weeks to a few months depending on how complex the file is
How decisions land: files meeting membership criteria are reviewed weekly by the medical director, with effective dates generally falling on the Thursday of the approval week. Files that do not meet criteria go to the credentials committee, which meets the second Wednesday of each month. You are notified within 10 business days of the decision
Reach: all of Nebraska, Iowa and South Dakota plus parts of Colorado, Wyoming, Kansas, Missouri, Illinois, Wisconsin and Minnesota, with more than 53,000 practitioners and 334 hospitals
Watch: it does not backdate applications except where Iowa or South Dakota law requires it for physicians. Nebraska has no such law, so the date you file is the date that counts

UnitedHealthcare and Optum

Two Nebraska entities, one behavioral door

Usually: 60 to 120 days from a complete application
Path: behavioral health starts inside Provider Express with Join Our Network, a separate application from core UnitedHealthcare medical
The Nebraska wrinkle: UnitedHealthcare sells through a national entity and through UnitedHealthcare of the Midlands, which is listed separately in Nebraska small-group filings. Confirm which entity and network your agreement names
Watch: the Community Plan (Heritage Health) line is a separate contract, its participation requests go through Onboard Pro, and since June 1, 2025 it denies claims from providers who are not enrolled with the state

Separate door: Optum Behavioral Health

Ambetter Health, issued by Celtic Insurance Company

The biggest individual book in the state, under a new name

Usually: Centene’s Nebraska statements are not consistent, so treat this as a range. The contracting FAQ says up to but no longer than 30 days once a completed contract and all credentialing documentation are in hand; the credentialing page says within 60 days of a complete application. Confirm at submission
Verification: primary source verification has run through Verisys since January 1, 2025. Recredentialing at least every 36 months
The entity change: this book was sold as Nebraska Total Care through plan year 2025, and for 2026 those enrollees moved to Ambetter Health plans issued by Celtic. The Medicaid side, Nebraska Total Care in Heritage Health, is unaffected
Watch: a Centene relationship here can reach both books, but they are separate contracts. Confirm the issuing entity on the Marketplace agreement

Medica

Number two on the exchange, with a caveat

Usually: 60 to 120 days from a complete application. Medica’s provider pages are gated, so we hedge this rather than sourcing a number to them, and we confirm at submission
Why it matters: roughly 15,300 individual members in 2025 and the largest 2025 ACA small-group book in the state at about 8,600 members
Watch the rate move: Medica took the biggest 2026 individual rate increase among Nebraska carriers, around 36.6 percent, so weigh its position before you build a Marketplace-heavy panel around it
Check the route first: Medica is named on the Midlands Choice payer resources page, so part of its Nebraska access may already run through that network

Aetna

Weight it by how much of your panel is employer group

Usually: a request for participation, then a network-need answer within about 45 days, then credentialing pulled from CAQH, then contracting. Commonly 60 to 120 days end to end
Path: behavioral health professionals use Aetna’s separate behavioral health request for participation, not the medical one
Watch: Aetna is a smaller presence in Nebraska’s individual market than BCBSNE or Ambetter, so size it against your expected mix before spending a cycle on it

Cigna Healthcare and Evernorth

Paused right now, nationally

Right now: Evernorth paused new individual and clinic behavioral health applications on June 1, 2026 and has signalled reopening after September 1. Facilities are exempt and pre-pause applications keep processing
Usually: Evernorth says the full behavioral network process can take up to about 90 days, with CAQH re-attestation every 120 days
Nebraska angle worth checking: Midlands Choice lists Cigna among its payer partners, so some Cigna member access here may run over that network. Confirm which network a given Cigna product uses before assuming Evernorth is the only door

Separate door: Evernorth Behavioral Health

Two more Nebraska carriers are live but narrow. Oscar Health had roughly 1,600 members in 2025 and is one of five carriers on the 2026 exchange, but it is also named on the Midlands Choice payer resources page, so check whether you already reach those members before signing a second agreement you may not need. Avera Health Plans is a plan year 2026 new entrant selling ACA small group coverage in seventeen northeast Nebraska counties, with no 2025 membership and no published Nebraska turnaround yet, so it is only worth your time if that is your corner of the state. Humana is a Medicare Advantage conversation here rather than a commercial one. Medicare, and Heritage Health and Medicaid work, are scoped and priced separately from a commercial package.

Carry a plan we didn’t list? Add it.

Nebraska has a few routes that never appear on a generic checklist. Self-funded employer plans administered by BCBSNE reach you through the administrator’s network rather than a separate employer contract, which is a practical argument for holding that agreement even when your insured-group volume looks modest. Nebraska Taft-Hartley union trusts usually rent a network too, and here that is frequently Midlands Choice or a national carrier. The six Regional Behavioral Health Authorities under the DHHS Division of Behavioral Health are not managed care at all: they are local units of government that contract with and purchase services from providers for uninsured and underinsured Nebraskans, which is a funding path rather than a credentialing one. And CyncHealth, the statewide health information exchange, is something the Heritage Health plans encourage after you’re contracted, not an enrollment requirement. You name the plan. We find the real route.

What we need from you

Send these once and we can start.

You give us this in one intake. Then we fill out the applications. No passwords, no patient information, and nothing gets submitted until you’ve read it and signed.

Your individual NPIPlus the group NPI if you bill under an entity. Nebraska requires every business location where services are rendered to be enrolled, and each enrollment carries a single NPI, so we need the full list up front.
Active Nebraska licence and DEATell us right away if your licence type changes. Nebraska Medicaid wants the old enrollment end dated and a new one submitted effective the new licence date, and late fixes are a common cause of denied retro requests and wrong-rate payments.
CAQH attested and authorizedYou attest it. We keep it current and never ask for your password. It is the base layer every commercial carrier here pulls from, and the Verisys arrangement on the Medicaid side sits alongside it rather than replacing it.
Delegated access to PDMSSo we can complete your state enrollment and each Heritage Health plan application without anyone sharing a password. Confirm the mailing address and email on file too, because that is where revalidation notices go and a missed revalidation closes the agreement.
Malpractice certificateYour current certificate naming you, or a carrier-produced roster face sheet.
Entity name, EIN and W-9One per tax ID you bill under. In Nebraska the tax ID, NPI and service address on file with each Heritage Health plan have to match your DHHS record exactly or claims will not pay, so we reconcile these before we submit.
Background check consent, timedWhere your enrollment category calls for a fingerprint criminal background check or a Nebraska abuse and neglect registry check. Results have short shelf lives, 30 days for fingerprints and 180 days for registry checks, so we schedule these rather than collecting them early.
Five years of work historyMonth and year, with any gap over six months explained. It lives in CAQH and it is the most common reason a clean-looking file comes back.

Some states make the practice itself hold a licence on top of your own. Nebraska’s version is narrower than most. The Mental Health Substance Use Treatment Center licence, issued by the DHHS Division of Public Health Licensure Unit under the Health Care Facility Licensure Act and Title 175 NAC 18, is written around a facility where people live for more than 24 consecutive hours, and the regulations expressly exclude services provided by licensed professionals in private practice caring for clients under their own licence. So it lands on residential and 24-hour programs rather than on outpatient medication management. A separate certification question can come up if you pursue a specialized Medicaid designation such as Certified Community Behavioral Health Clinic, which Nebraska Medicaid added as a provider type. We confirm the current category definitions with DHHS during intake, before either one can hold up a payer contract or an enrollment. We don’t give legal advice and we don’t file it for you.

How it works

You answer once. We do the paperwork.

You can buy online without a meeting. Published price, published scope, no call needed unless you want one.

Buy the package

Published price and scope. No call needed.

One intake

Short and guided. It asks more only where your answers call for it.

We prepare everything

PDMS enrollment, the three Heritage Health plan applications and every commercial file, built from what you told us.

You review and sign

Read it, change anything, sign. Nothing goes out until you say so.

We submit and track

Every purchase includes Command Suite, so you can see where each payer application stands, what we’re working on, what’s waiting on a payer, and what we still need from you.

What we stand behind

Payer decisions, timing and rates are not ours to promise, and we don’t promise them. Our own work is a different matter. If something we delivered does not work the way we said it would, we fix it at no charge for 30 days after delivery, including one stabilization review. A new request, another payer or provider, a change of scope, or a new build is quoted separately. You won’t get an invoice for correcting our mistake.

Built to keep working after we’re done

Everything we set up is built for the practice you are growing into, not only the one you have today. Adding a provider or a second location should be a configuration change rather than a rebuild. When the engagement ends you own the accounts, the documentation and the systems, and they keep running without us. No lock-in.

Questions we get

Nebraska credentialing questions

What is Midlands Choice, and do I actually need it?

It is an Omaha-based regional PPO owned by three of the largest health systems in Nebraska and Iowa, leased by self-funded employers and third-party administrators. Whether you need it comes down to one number: the Department of Insurance reports that 66.8 percent of Nebraskans in employment-based plans were in a self-insured plan in 2023, and self-funded employers are exactly who lease this network. So a card carrying an employer or administrator name you have never heard of may still route through Midlands Choice. It also names Cigna, Medica, Oscar Health and HealthPartners on its payer resources page, which means one contract can be the practical door to several carriers here. It credentials advanced nurse practitioners and master’s level behavioral health clinicians, so eligibility is not the question. Effort is, and the effort usually pays for itself in this state.

Do all three Heritage Health plans credential me separately?

The verification happens once. Since January 1, 2025, Verisys has been the centralized vendor doing primary source verification for all of the Nebraska Medicaid managed care organizations, so licensure, board certification, education and adverse action checks are done one time instead of three. What it does not do is merge the contracts. You still apply to, sign with and get a separate effective date from Nebraska Total Care, Molina Healthcare of Nebraska and UnitedHealthcare Community Plan. All three are statewide, covering every Medicaid and CHIP member in every county, so a Nebraska behavioral health practice usually credentials with all three rather than picking by region. Behavioral health sits inside those same plans, so there is no separate behavioral payer to chase.

Will anyone pay me for the wait in Nebraska?

No, on both sides, and this is the thing to plan around. The Health Care Professional Credentialing Verification Act, Neb. Rev. Stat. 44-7001 to 44-7013, governs how a carrier credentials: written policies and procedures, verification before contracting, a credentialing committee of licensed clinicians, your right to review the information gathered about you and correct anything wrong, and five-year record retention. What it does not do is set a deadline for a decision or require anyone to pay you for services delivered while you waited. Neighboring Iowa does both under Iowa Code 514F.6. You can hear the difference in a payer’s own words: Midlands Choice states it does not backdate applications except as required by law for Iowa and South Dakota physicians, and Nebraska is not on that list. On the Medicaid side, the state’s enrollment vendor says retroactive dates for mental health providers are rarely considered.

How fast does a Nebraska insurer have to pay a clean claim?

The Health Care Prompt Payment Act, Neb. Rev. Stat. 44-8001 to 44-8010, passed as LB 389 in 2005, requires a clean claim to be paid, denied or settled within 30 calendar days if you submitted it electronically and 45 calendar days otherwise. If the insurer needs more information it has to tell you in writing within 30 days, and the clock is tolled until you supply it. Two limits matter and they are not small. An insurer that files a valid compliance statement with the Department of Insurance by December 1 each year is exempt from the interest requirement on late clean claims, and the Department publishes the list of who filed. And the Act does not reach self-insured plans or Medicaid. In a state where two thirds of employer coverage is self-funded, that is a large hole in the middle of the protection.

Do I have to enroll with Nebraska Medicaid if I only see commercial patients?

If you prescribe for anyone on Nebraska Medicaid, treat it as yes. Prescription claims are rejected when the prescriber is not active, which bites prescribers who rarely bill Medicaid directly but write for Medicaid patients. Separately, the Heritage Health plans deny claims from providers who are not enrolled with the state, and UnitedHealthcare Community Plan has done so since June 1, 2025, so state enrollment comes first even if every patient you see is a managed care member. Nebraska also requires every business location where services are rendered to be enrolled, with a single NPI per enrollment, so a second office is a second enrollment rather than an address update. Paper applications ended June 1, 2025, so all of this runs through the PDMS portal.

What happened to Nebraska Total Care on the Marketplace?

Read the entity change carefully, because the name still appears in two places and they behave differently. This individual-market book was sold as Nebraska Total Care through plan year 2025, and for plan year 2026 those enrollees moved to Ambetter Health plans issued by Celtic Insurance Company. Technically that was a Nebraska Total Care withdrawal from the individual line. The Medicaid side, Nebraska Total Care in Heritage Health, is unaffected and continues as one of the three statewide plans. A Centene relationship in Nebraska can reach both books, but they are separate contracts with separate effective dates, so confirm the current issuing entity on any Marketplace agreement before you sign it.

Where does a UnitedHealthcare behavioral health application go in Nebraska?

Through Optum, inside Provider Express, using the Join Our Network flow. It is a separate application from core UnitedHealthcare medical, and applying at the medical door is the most common and most expensive mistake in a commercial credentialing run. Nebraska has one extra wrinkle: UnitedHealthcare sells through both a national entity and UnitedHealthcare of the Midlands, and the Midlands entity is listed separately in Nebraska small-group filings, so confirm which entity and network your agreement actually names. On the Medicaid side, Community Plan participation requests go through Onboard Pro on the UnitedHealthcare provider portal and verification runs through Verisys. Cigna’s behavioral door is Evernorth, Aetna wants its own behavioral request for participation, and BCBSNE handles it inside the plan.

Do you need my CAQH password?

No, and we won’t ask. We’re added as an authorized practice manager, which lets us keep your practice data current and authorize payers. You complete and attest your own profile, and you sign anything that needs your signature. Anyone asking a provider for their CAQH password is doing it wrong. Nebraska has no state-designated credentialing database, so CAQH is the base layer the commercial carriers pull from, and the Verisys arrangement on the Medicaid side sits alongside it rather than replacing it. One Nebraska-specific thing to get right early: Blue Cross and Blue Shield of Nebraska runs separate application tracks for new practitioners, provisional providers, delegated and PHO-affiliated providers and facilities, and starting on the wrong track costs weeks before anybody notices.

Keep reading

Nebraska PMHNP scope of practiceWhat Nebraska allows you to do, separate from who pays you.
Iowa credentialingA 56-day clock and retrospective payment, which is exactly what Nebraska lacks.
Kansas credentialingOne KMAP application picks your KanCare plans, and both Blues route behavioral health through Lucet.
Missouri credentialingA 60-day clock, back pay through the credentialing period, and two separate Blue front doors.
South Dakota credentialingPure fee-for-service Medicaid, plus a 90-day clock and an any-willing-provider law.
Opening your own practiceEntity, identifiers, payers, EHR and billing setup.
Adding a provider to your clinicFirst-time credentialing into contracts you already hold.
Changing your entity or tax IDMoving panels without breaking the money.

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Where this comes from

Nebraska DHHS, Medicaid provider screening and enrollment through the Maximus PDMS portal, paper applications ended June 1, 2025 verified July 26, 2026
Nebraska DHHS, Heritage Health: the three participating plans and the integrated physical, behavioral, pharmacy and dental benefit verified July 26, 2026
Maximus, Nebraska Medicaid provider enrollment newsletter: retroactive dates rarely considered for mental health providers, revalidation notices and closure, background check shelf lives verified July 26, 2026
Nebraska Total Care, credentialing: Verisys as the centralized verification vendor for all Nebraska managed care organizations effective January 1, 2025 verified July 26, 2026
Nebraska Legislature, Health Care Professional Credentialing Verification Act, Neb. Rev. Stat. 44-7001 to 44-7013, and the dental-only network access rule at 44-7,110 verified July 26, 2026
Nebraska Legislature, Health Care Prompt Payment Act, Neb. Rev. Stat. 44-8001 to 44-8010, with the Department of Insurance alert on the December 1 compliance statement and the self-insured exclusion verified July 26, 2026
Nebraska Department of Insurance, plan year 2026 market briefing: carrier roster, 2025 membership by carrier, and the 66.8 percent self-insured figure for 2023 verified July 26, 2026
Midlands Choice, network participation, credentialing FAQs and the payer resources page verified July 26, 2026
Blue Cross and Blue Shield of Nebraska, credentialing application tracks and post-approval NaviNet workflow verified July 26, 2026

Written by Ryan Berg, founder of AdvanceAPractice. 16 years in healthcare revenue cycle and credentialing.

Facts on this page were verified July 26, 2026 and are next due for review October 26, 2026.

Payer programs, plans and timelines change. Everything here carries a verification date and gets re-checked on a review cycle; this record is next due for review on October 26, 2026. Approval and effective dates are controlled by each payer and by the state, and nothing here promises an approval, a timeline or a rate. This page covers payer operations. It isn’t legal, tax or scope of practice advice.