Nevada Medicaid and Nevada Check Up News (Second Quarter 2026 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]

Notifications

IMPORTANT: Nevada Medicaid is conducting a swift revalidation effort on high risk providers. If selected, you will receive a revalidation notice with instructions through the standard communication process. See Web Announcement 3935 for more information.

Known System Issues-Click HERE

Top 10 Claim Denial Reasons and Resolutions/Workarounds for September 2026 Professional Claims. See Web Announcement 4031.

Top Prior Authorization Denial Reasons for the Second Quarter of 2026. See Web Announcement 3978.

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 https://NevadaMedicaid.nv.gov/ and the Billing Guide for your provider type at www.medicaid.nv.gov.

Scheduled Site Maintenance

During the scheduled site maintenance window the Provider Web Portal will be unavailable. The table below shows the regularly scheduled maintenance window. All times will be in the Pacific time zone.

Monday - Friday
12:00AM - 12:30AM

Monday
8:00PM - 12:00AM

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... /LOC in the Provider Web Portal (PWP) Accessing the PASRR/LOC System Accessing the PASRR/LOC System You must be a registered user of the ...
Terms matched: 1  -  Score: 239  -  27 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PASRR_LOC_NF_Training_2021.pdf
... to a particular organization, it is imperative that the user be removed from the system. In order to remove a user, please follow the instructions below. ...
Terms matched: 1  -  Score: 20  -  27 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PASRR_PWP_QRG.pdf
... a.m. All times listed are Pacific Time (PT) . What are the system Browsers: Microsoft Internet Explorer 9.0 and later or Mozilla Firefox or Google Chrome ...
Terms matched: 1  -  Score: 59  -  23 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/EVS_FAQ.pdf
... contact Nevada Medicaid’s TPL vendor: incorrect commercial TPL or Health Management Systems, Inc. (HMS) Medicare Replacement information Phone: 775-335-1040 or Toll ...
Terms matched: 1  -  Score: 23  -  23 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/TPL_Frequently_Asked_Questions.pdf
... /2019 Updates made throughout per the implementation of the All modernized Medicaid Management Information System (MMIS) 03/18/2019 Updates made throughout All sections 11 ...
Terms matched: 1  -  Score: 270  -  22 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
... /2019 Updates made throughout per the implementation of the All modernized Medicaid Management Information System (MMIS) 03/18/2019 Updates made throughout All sections 11 ...
Terms matched: 1  -  Score: 270  -  22 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20261008.pdf
... Medicaid Fee for Services (FFS) recipients are billed through the FFS benefit delivery system. Benefit coverage, with limitations and prior authorization requirements can be found on ...
Terms matched: 1  -  Score: 74  -  22 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22.pdf
... Medicaid Fee for Services (FFS) recipients are billed through the FFS benefit delivery system. Benefit coverage, with limitations and prior authorization requirements can be found on ...
Terms matched: 1  -  Score: 74  -  22 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22_20260701.pdf
... . Please note that the requirement extends to pharmacy Point of Sale (POS) systems as well. The POS system will deny, at the time of the ...
Terms matched: 1  -  Score: 77  -  21 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/OPR_FAQs.pdf
... HCPCS Codes The allowable Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes to be billed for Community Paramedicine services are available on ...
Terms matched: 1  -  Score: 21  -  21 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT32_Spec_249_online_20260727.pdf
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