Nevada Medicaid and Nevada Check Up News (First 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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Top 10 Claim Denial Reasons and Resolutions/Workarounds for April 2026 Professional Claims. See Web Announcement 3915.

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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. PT_34_Therapy_Tip_Sheet.pdf
... Authorization Nevada Medicaid Criteria YouTube: PA Search Overview Provider Day Calculator Web Portal Fee WA 1728 Schedule (FA-7 Search Information) Nevada WA 3609 Medicaid (Medical Record ...
Terms matched: 1  -  Score: 35  -  12 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PT_34_Therapy_Tip_Sheet.pdf
2. Error_Code_to_EOB_to_ANSI.pdf
... Crosswalk ERROR_CODE ERROR_CODE_DESCRIPTION EOB_CODE EOB_CODE_DESCRIPTION REASON_CODE REASON_CODE_DESCRIPTION REMARK_CODE REMARK_CODE_DESCRIPTION 247 MAXIMUM NUMBER OF CLAIM DETAILS 5310 The detail lines are missing or the maximum 16 Claim/service lacks information ...
Terms matched: 1  -  Score: 28  -  06 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
3. NV_BillingGuidelines_PT25-41_20241218.pdf
... therapy • Qualifying eyeglass lenses and frames with a prescription • Polycarbonate lenses See MSM Chapter 1100 on the DHCFP website for a complete list of ...
Terms matched: 1  -  Score: 44  -  03 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT25-41_20241218.pdf
4. NV_BillingGuidelines_PT25-41.pdf
... therapy • Qualifying eyeglass lenses and frames with a prescription • Polycarbonate lenses See MSM Chapter 1100 on the Nevada Medicaid website for a complete list ...
Terms matched: 1  -  Score: 44  -  03 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT25-41.pdf
5. web_announcement_3560_20250220.pdf
... provider website For more information about PT 93, see the following web announcements (WA): • WA 3383 • WA 3452 †...
Terms matched: 1  -  Score: 124  -  20 Feb 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3560_20250220.pdf
6. web_announcement_3521_20250103.pdf
... , replacement) â€" 2 per 12 months • A4285 (Polycarbonate bottle for use with breast pump, replacement) â€" 2 per ...
Terms matched: 1  -  Score: 20  -  03 Jan 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3521_20250103.pdf
7. NV_BillingGuidelines_PT25-41_20240905.pdf
... therapy • Qualifying eyeglass lenses and frames with a prescription • Polycarbonate lenses See MSM Chapter 1100 on the DHCFP website for a complete list of ...
Terms matched: 1  -  Score: 44  -  18 Dec 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT25-41_20240905.pdf
8. NV_BillingGuidelines_PT20-24-77_online_120524_to_121824.pdf
... therapy • Qualifying eyeglass lenses and frames with a prescription • Polycarbonate Lenses Prior authorization is required for procedure code V2784 (Lens, polycarbonate or ...
Terms matched: 1  -  Score: 24  -  18 Dec 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT20-24-77_online_120524_to_121824.pdf
9. NV_BillingGuidelines_PT20-24-77_online_090524_to_120524.pdf
... therapy • Qualifying eyeglass lenses and frames with a prescription • Polycarbonate Lenses Prior authorization is required for procedure code V2784 (Lens, polycarbonate or ...
Terms matched: 1  -  Score: 24  -  05 Dec 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT20-24-77_online_090524_to_120524.pdf
10. Incretin_Mimetics_2013-0812.pdf
... Incretin Mimetics 2013 0812 ...
Terms matched: 1  -  Score: 16  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Incretin_Mimetics_2013-0812.pdf
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