Nevada Medicaid and Nevada Check Up News (Fourth Quarter 2025 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 February 2026 Professional Claims. See Web Announcement 3863.

Top Prior Authorization Denial Reasons for the Fourth Quarter of 2025. See Web Announcement 3830.

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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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 ... . condition. 360 ADMITTING DIAGNOSIS MISSING 60 Admit Diagnosis is missing or invalid. ...
Terms matched: 2  -  Score: 173  -  09 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
2. NV_BillingGuidelines_PT25-41.pdf
... 12 months per eye per recipient. The service limit for V2628 is once every 60 months per eye per recipient. • For eyeglasses, recipients age ...
Terms matched: 1  -  Score: 21  -  03 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT25-41.pdf
3. NV_BillingGuidelines_PT25-41_20241218.pdf
... 12 months per eye per recipient. The service limit for V2628 is once every 60 months per eye per recipient. • For eyeglasses, recipients age ...
Terms matched: 1  -  Score: 21  -  03 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT25-41_20241218.pdf
4. Provider_Enrollment_Information_Booklet.pdf
... Private Case Management Services • 959: Facility Based Assisted Living School Based 60 Specialty type code: • 960: School Based Residential Treatment Center ...
Terms matched: 1  -  Score: 36  -  27 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
5. NV_Billing_General_20260101.pdf
... receive a letter notifying them when to revalidate. Providers who do not revalidate within 60 days of the date on their notification will have their provider contract terminated. ...
Terms matched: 1  -  Score: 24  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20260101.pdf
6. NV_Billing_General.pdf
... receive a letter notifying them when to revalidate. Providers who do not revalidate within 60 days of the date on their notification will have their provider contract terminated. ...
Terms matched: 1  -  Score: 24  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
7. NV_EVS_User_Manual_Ch1.pdf
... Delegate accounts will be considered inactive when the last log in date is greater than 60 days from the current date. After 60 days of inactivity, the delegate ...
Terms matched: 1  -  Score: 42  -  18 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch1.pdf
8. NV_Flex_User_Guide_Getting_Started.pdf
... with the account. 1.5. Expired Password Once registered, passwords will expire every 60 days. Users will see a Password Expiration notification. Updating the password in ...
Terms matched: 1  -  Score: 12  -  18 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Flex_User_Guide_Getting_Started.pdf
9. Known_Issues.pdf
... Resolution/Work Around Date Date Recycle Date # Reported Resolved (If Applicable) 60 Claims, Some institutional claims are being denied • Provider: No ...
Terms matched: 1  -  Score: 50  -  17 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
10. NV_EVS_User_Manual_Ch3.pdf
... example (Professional claim): 59 Detail level example (Professional claim): 60 Institutional claims • The total payment by other insurers must be entered ...
Terms matched: 1  -  Score: 12  -  17 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch3.pdf
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