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]

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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 4053.

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.

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1. Error_Code_to_EOB_to_ANSI.pdf
... REMARK_CODE_DESCRIPTION 247 MAXIMUM NUMBER OF CLAIM DETAILS 5310 The detail lines are missing or the ... REF), if present. 1062 ORDERING NPI REQUIRED 1062 Ordering NPI is required ...
Terms matched: 2  -  Score: 165  -  12 Nov 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
2. Quick_Tip_Guide_Inpatient_Med_Surg.pdf
... Medical History and Physical Exam. • Consultations. • Physician Orders. • Labs. • Imaging Reports. †...
Terms matched: 1  -  Score: 21  -  05 Nov 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Quick_Tip_Guide_Inpatient_Med_Surg.pdf
3. Quick_Tip_Guide_Outpatient_Med_Surg.pdf
... ¢ Make sure the treatment plan matches your request and the physician’s order. ELECTROMYOGRAPHY AND NERVE CONDUCTION STUDIES (EMG/NCS): †...
Terms matched: 1  -  Score: 20  -  05 Nov 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Quick_Tip_Guide_Outpatient_Med_Surg.pdf
4. NV_EVS_User_Manual_Ch9.pdf
... Support, Psychologist, Special Clinics, Substance Use Treatment, and Vision provider in order to use this function.â€On the “Dentalâ€tab: â ...
Terms matched: 1  -  Score: 35  -  28 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch9.pdf
5. PASRR_PWP_QRG.pdf
... Note: you need to be a registered user within the Provider Web Portal in order to successfully log in to the PASRR application.) 2) Go to ...
Terms matched: 1  -  Score: 41  -  27 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PASRR_PWP_QRG.pdf
6. PASRR_LOC_NF_Training_2021.pdf
... €¢ The “Submitâ€button may be selected by the user in order to submit PASRR screen. Nevada Medicaid â€" PASRR / LOC / ...
Terms matched: 1  -  Score: 34  -  27 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PASRR_LOC_NF_Training_2021.pdf
7. PT29_PA_FAQ.pdf
... home health care by the agency and the recipient received the first skilled service as ordered under the POC, the visit becomes the first billable visit as an RN ...
Terms matched: 1  -  Score: 20  -  23 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PT29_PA_FAQ.pdf
8. NV_Billing_General.pdf
... with Medicaid to render urgent/emergency services. Providers who are enrolled as an Ordering, Prescribing or Referring (OPR) provider cannot bill for services rendered to ...
Terms matched: 1  -  Score: 35  -  22 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
9. NV_Billing_General_20261008.pdf
... with Medicaid to render urgent/emergency services. Providers who are enrolled as an Ordering, Prescribing or Referring (OPR) provider cannot bill for services rendered to ...
Terms matched: 1  -  Score: 35  -  22 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20261008.pdf
10. NV_BillingGuidelines_PT22.pdf
... ) providers are instructed to submit dental claims with tooth surface codes indicated in alphabetical order. Managed Care (LIBERTY Dental Plan) Recipients Dental services provided to Managed ...
Terms matched: 1  -  Score: 27  -  22 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22.pdf
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