Nevada Medicaid and Nevada Check Up News (Fourth Quarter 2024 Provider Newsletter) [Read]

Attention Behavioral Health Providers: Monthly Behavioral Health Training Assistance (BHTA) Webinar Scheduled [See Web Announcement 2009]

Attention All Providers: Requirements on When to Use the National Provider Identifier (NPI) of an Ordering, Prescribing or Referring (OPR) Provider on Claims [Announcement 850]

If you are a Medicaid provider whose revalidation application has not been processed by your termination due date, you will be ineligible to provide services to any Nevada Medicaid or Nevada Check Up recipients, including both Fee-for-Service and Managed Care Organization (MCO) enrolled recipients. See Web Announcement 1265

Enrollment Termination Frequently Asked Questions (FAQs) [Review]

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NOTIFICATION:The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. to midnight Pacific Time Sunday, January 26, 2025, for scheduled maintenance:
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Paper claims are no longer accepted by Nevada Medicaid. Please refer to Web Announcement 1733 and Web Announcement 1829 for additional information.

Top 10 Claim Denial Reasons and Resolutions/Workarounds for December 2024 Professional Claims. See Web Announcement 3538.

Top Enrollment Return Reasons and Resolutions for January 2024 Submissions. See Web Announcement 3350.

Top Prior Authorization Denial Reasons for the Third Quarter of 2024. See Web Announcement 3488.

Attention Providers Using the Authorization Criteria Function: Results that return prior authorization (PA) requirements are accurate. For results that return “There are no records found based on the search criteria,” there may be a PA requirement if limits have been exceeded. To verify PA requirements, please refer to the Medicaid Services Manual (MSM) Chapter for your service type at dhcfp.nv.gov and the Billing Guide for your provider type at www.medicaid.nv.gov.

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371. Anthem_DUR_Binder_July_2020.pdf
... to NV DUR Board on July 23, 2020 Psychotropic Agents DRUG USE REVIEW BOARD MCO PRIOR AUTHORIZATION CRITERIA REVIEW FORM Clinical criteria for drugs or drug classes listed on ...
Terms matched: 1  -  Score: 92  -  16 Jun 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Anthem_DUR_Binder_July_2020.pdf
372. FFS_DUR_Binder_July_2020.pdf
... RM. Bipolar disorder in adults: choosing maintenance treatment. UpToDate Web site. ... Carl has presented based off the other MCO recommendations? Dave England: This is ...
Terms matched: 2  -  Score: 73  -  16 Jun 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FFS_DUR_Binder_July_2020.pdf
373. NV_BillingGuidelines_PT43_20191226.pdf
... EPSDT) program. Managed Care For recipients enrolled in a Managed Care Organization (MCO), it is the laboratory’s responsibility to comply with all ...
Terms matched: 1  -  Score: 41  -  09 Jun 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT43_20191226.pdf
374. Antidepressants_SSRIs_2020-0608.pdf
... of PTSD (VA/DoD 2017) â — ‹ For those patients who choose not to engage in or are unable to access trauma-focused psychotherapy, the use ...
Terms matched: 1  -  Score: 24  -  08 Jun 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Antidepressants_SSRIs_2020-0608.pdf
375. Opioid_Use_Disorder_Agents_2020-0608.pdf
... Opioid Treatment Program. In addition, DATA reduced the regulatory burden on physicians who choose to practice opioid addiction therapy by permitting qualified physicians to apply for and receive ...
Terms matched: 1  -  Score: 16  -  08 Jun 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Opioid_Use_Disorder_Agents_2020-0608.pdf
376. Antidepressants_Other_2020-0608.pdf
... July 2016. • Simon G. Unipolar major depression in adults: Choosing initial treatment. UpToDate Web site. www.uptodate.com. Updated December 23, 2015 ...
Terms matched: 1  -  Score: 12  -  08 Jun 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Antidepressants_Other_2020-0608.pdf
377. Anticonvulsants_2020-0608.pdf
... ; November 2017. • Post RM. Bipolar disorder in adults: choosing maintenance treatment. UpToDate Web site. www.uptodate.com. Updated November 9, 2019 ...
Terms matched: 1  -  Score: 10  -  08 Jun 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Anticonvulsants_2020-0608.pdf
378. Atypical_Antipsychotics_2020-0608.pdf
... 2020. • Stovall J. Bipolar mania and hypomania in adults: choosing pharmacotherapy. UpToDate website. 2020[b ] . www.uptodate.com/ . Accessed ...
Terms matched: 1  -  Score: 10  -  08 Jun 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Atypical_Antipsychotics_2020-0608.pdf
379. NV_BillingGuidelines_PT55_20200309.pdf
... provider. Note: PT 55 procedure codes are carved out of Managed Care (MCO) and services are paid out of FFS. (T2020 and T2017, ...
Terms matched: 1  -  Score: 20  -  18 May 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT55_20200309.pdf
380. E-Binder_SSSB_June_2020.pdf
... 2020. • Stovall J. Bipolar mania and hypomania in adults: choosing pharmacotherapy. UpToDate website. 2020[b ] . www.uptodate.com/ . Accessed ...
Terms matched: 1  -  Score: 32  -  15 May 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_SSSB_June_2020.pdf
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