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.

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1. 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  -  09 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
2. FA-24A.pdf
... AM Mid PM AM Mid PM AM Mid PM AM Mid PM Bathing Dressing Grooming Toileting Transfer/Positioning Mobility/Ambulation Eating Housekeeping Laundry Essential Shopping Meal Preparation FA-24A ...
Terms matched: 1  -  Score: 21  -  16 Jul 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-24A.pdf
3. FA-24W.pdf
... tasks does the individual need assistance with? â Bathing â Dressing â Grooming â Toileting â Transferring â Positioning â Ambulation â Eating â Meal Preparation â Laundry â ...
Terms matched: 1  -  Score: 20  -  16 Jul 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-24W.pdf
4. FA-1B.pdf
... and limitations: 10. Describe age-appropriate bowel and bladder continence/incontinence (include toilet training, frequency of incontinent episodes, interventions, need for self catheterizations, ...
Terms matched: 1  -  Score: 36  -  09 May 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-1B.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. 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
7. Immunomodulators_2015-0812.pdf
... Immunomodulators 2015 0812 ...
Terms matched: 1  -  Score: 16  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Immunomodulators_2015-0812.pdf
8. Immunomodulators_2013-0812.pdf
... Immunomodulators 2013 0812 ...
Terms matched: 1  -  Score: 16  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Immunomodulators_2013-0812.pdf
9. IBS_and_Constipation_Agents_2018-0613.pdf
... , morning tablets Patient should be within close OIC in advanced illness: proximity to toilet facilities after Weight-based SC injection administration. once every other day, as needed ...
Terms matched: 1  -  Score: 12  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/IBS_and_Constipation_Agents_2018-0613.pdf
10. HMG_CoA_Reductase_Inhibitors_2013-0812.pdf
... JR 3rd, Raichlen JS, Riley WA, Evans GW, Palmer MK, ... HMG CoA Reductase Inhibitors 2013 0812 ...
Terms matched: 2  -  Score: 22  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/HMG_CoA_Reductase_Inhibitors_2013-0812.pdf
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