Many young children who experience trauma may find it difficult to communicate their experiences through traditional talk therapy. For these children, play therapy can play an important role.
That is why State Senator John Fredrickson introduced LR382 during this year’s legislative session, an interim study examining issues related to access to play therapy. The Legislature’s Health and Human Services Committee will hold a hearing on LR382 on September 16. First Five Nebraska (FFN) supports these efforts to improve access to play therapy for Nebraska children.
What is play therapy?
Play therapy is a structured, evidence-based psychotherapy approach that utilizes specialized therapeutic play as the primary medium of healing instead of traditional talk therapy. Because young children often lack the ability to articulate complex trauma verbally, therapeutic play allows trained clinicians to establish a unique relational entry point to help the child process severe distress, abuse and attachment disruptions. Play therapy is often used by the child welfare system to meet the developmental needs of children.
Why is play therapy difficult to access in Nebraska?
Play therapy has not been recognized by Nebraska Medicaid as an independent treatment modality, even though more than 33 states, including all states bordering Nebraska, allow play therapy services to be offered to children covered by Medicaid. Because play therapy is not recognized as a Medicaid service in Nebraska, any therapeutic service to children that has any element of play, either play-related language or references to play, is often denied. More recently, several Nebraska mental health providers have been audited and forced to return over $1 million to Medicaid for any service notes that include the word “play.” Many providers, particularly in rural areas, have discontinued working with Nebraska Medicaid or children who need play therapy at the risk of not receiving payment, or worse, receiving payment and having to return it later.
What is the solution?
Nebraska Medicaid needs to revise their regulations to recognize play therapy as a stand-alone treatment modality. At the end of 2025, Nebraska Medicaid did offer revisions that created greater recognition of play therapy. However, they stop short of acknowledging the service as an independent treatment modality. Without clear guidance, interpretation of these regulations may vary among payers, continuing the risk of claim denials, audits and recoupments.
Moving forward
We hope this interim study will lead to Nebraska Medicaid revising its regulations to help ensure Nebraska children are able to access appropriate mental health care. We thank Senator Fredrickson for bringing this important interim study and are proud to work with him to improve access to play therapy for children across Nebraska.
