Nebraska
Medicaid Program
Provider Infomation
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:  Contacts.
Regulations
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 |
Provider Bulletins
Go to Rules and Regulations and Provider Bulletins for all Medicaid regulations,
appendices and bulletins.
Documents in PDF format require the use of Adobe Acrobat Reader which
can be dowloaded for free from Adobe Systems,
Inc. |
