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 July 2026 Professional Claims. See Web Announcement 3983.

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.

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1. NV_BillingGuidelines_PT22.pdf
... Provider Type 22 Billing Guide Dentist Dental Services Program Overview Recipients Age 21 and Older Adult Medicaid recipients may receive the following dental services subject to a $1 ...
Terms matched: 1  -  Score: 232  -  01 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22.pdf
2. NV_BillingGuidelines_PT22_20230327.pdf
... Provider Type 22 Billing Guide Dentist Dental Services Program Overview Recipients age 21 and older may receive emergency extractions, palliative care, and dentures/prosthetic care under ...
Terms matched: 1  -  Score: 193  -  01 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22_20230327.pdf
3. NV_BillingGuidelines_PT22-attachmentA_03-23-26.pdf
... , D0374 and/or D0387. Updated 03/23/2026 pv01/29/2026 Attachment A Page 1 of 15 Service for Persons Service for Persons ...
Terms matched: 1  -  Score: 193  -  01 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentA_03-23-26.pdf
4. NV_BillingGuidelines_PT17_Spec181.pdf
... Provider Type 17 Specialty 181 Billing Guide Special Clinics: Federally Qualified Health Centers (FQHC) Program Overview Federally Qualified Health Centers (FQHCs) are defined by ...
Terms matched: 1  -  Score: 318  -  01 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT17_Spec181.pdf
5. NV_BillingGuidelines_PT17_Specialty_181_20260306.pdf
... Provider Type 17 Specialty 181 Billing Guide Special Clinics: Federally Qualified Health Centers (FQHC) Program Overview Federally Qualified Health Centers (FQHCs) are defined by ...
Terms matched: 1  -  Score: 305  -  01 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT17_Specialty_181_20260306.pdf
6. NV_BillingGuidelines_PT34.pdf
... Provider Type 34 Billing Guide Therapy Where to find state policy The Medicaid Services Manual (MSM) Chapter 1700 contains State policy for all therapy services, including ...
Terms matched: 1  -  Score: 215  -  02 Jun 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT34.pdf
7. NV_BillingGuidelines_PT34_2026-0101.pdf
... Provider Type 34 Billing Guide Therapy Where to find state policy The Medicaid Services Manual (MSM) Chapter 1700 contains State policy for all therapy services, including ...
Terms matched: 1  -  Score: 215  -  02 Jun 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT34_2026-0101.pdf
8. NV_BillingGuidelines_PT60.pdf
... Provider Type 60 Billing Guide School Health Services ( ... Billing Guide pv 04/29/2026 1 / ... 04/29/2026 72 / 79 Provider Type ...
Terms matched: 3  -  Score: 793  -  19 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60.pdf
9. NV_BillingGuidelines_PT60_2026-0429.pdf
... Provider Type 60 Billing Guide School Health Services ( ... . 77 Updated 04/29/2026 Provider Type ... 12/16/2025 72 / 78 Provider Type ...
Terms matched: 3  -  Score: 784  -  19 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60_2026-0429.pdf
10. NV_BillingGuidelines_PT97.pdf
... Provider Type 97 Billing Guide Peer Support Services State Policy Nevada Medicaid’s policies can be found on the Nevada Medicaid website, https:// ...
Terms matched: 1  -  Score: 147  -  19 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT97.pdf
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