471 NAC 20-014. OBSERVATION ROOM SERVICES (23:59)

014. OBSERVATION ROOM SERVICES (23:59). When appropriate for brief crisis stabilization, Nebraska Medicaid covers outpatient hospital observation room services up to 23 hours 59 minutes in an emergency room or acute hospital with the following qualifiers: (A)If a beneficiary receives 24 or more hours of continuous outpatient care, that beneficiary is defined as an inpatient regardless of the hour of admission, whether they used a bed, and whether they remained in the hospital past midnight or the census-taking hour; (B)When the beneficiary reaches 24 hours of continuous outpatient care, all inpatient medical review prior-authorization requirements noted in this chapter apply; and (C)The services must be billed as an outpatient hospital psychiatric service on the appropriate Nebraska Medicaid approved health care claim form .