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 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_Billing_General_20260710.pdf
... by the American Medical Association (AMA), and the American Dental Association (ADA), respectively, all rights reserved. AMA and ADA assume no liability ...
Terms matched: 1  -  Score: 52  -  08 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20260710.pdf
2. NV_Billing_General.pdf
... by the American Medical Association (AMA), and the American Dental Association (ADA), respectively, all rights reserved. AMA and ADA assume no liability ...
Terms matched: 1  -  Score: 52  -  08 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
3. Error_Code_to_EOB_to_ANSI.pdf
... REMARK_CODE_DESCRIPTION 247 MAXIMUM NUMBER OF CLAIM DETAILS 5310 The detail lines are missing or the ... code(s ) . AMA or ADA for the Date of Service. submission ...
Terms matched: 2  -  Score: 31  -  06 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
4. NV_BillingGuidelines_PT22-attachmentA.pdf
... copyrighted by the American Medical Association (AMA) and the American Dental Association (ADA), respectively, all rights reserved. CPT is a registered trademark  ...
Terms matched: 1  -  Score: 28  -  28 Sep 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentA.pdf
5. NV_BillingGuidelines_PT22-attachmentA_09-16-26.pdf
... copyrighted by the American Medical Association (AMA) and the American Dental Association (ADA), respectively, all rights reserved. CPT is a registered trademark  ...
Terms matched: 1  -  Score: 28  -  28 Sep 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentA_09-16-26.pdf
6. web_announcement_4011_20260922.pdf
... ), Healthcare Common Procedure Coding System (HCPCS) and American Dental Association (ADA) codes that were added for Quarter 4 2026. Effective with claims processed ...
Terms matched: 1  -  Score: 21  -  22 Sep 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_4011_20260922.pdf
7. NV_BillingGuidelines_PT22-attachmentA_07-01-26.pdf
... copyrighted by the American Medical Association (AMA) and the American Dental Association (ADA), respectively, all rights reserved. CPT is a registered trademark  ...
Terms matched: 1  -  Score: 31  -  17 Sep 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentA_07-01-26.pdf
8. web_announcement_4007_20260916.pdf
... ), Healthcare Common Procedure Coding System (HCPCS) and American Dental Association (ADA) codes that were added for Quarter 4 2026. Effective with claims processed ...
Terms matched: 1  -  Score: 21  -  16 Sep 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_4007_20260916.pdf
9. NCPDP_Encounter_Companion_Guide.pdf
... insurance and insurance-related business processes. www.x12.org. • American Dental Association (ADA): Develops and maintains a standardized data set for use by dental organizations ...
Terms matched: 1  -  Score: 11  -  15 Sep 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NCPDP_Encounter_Companion_Guide.pdf
10. NV_BillingGuidelines_PT22-attachmentB_12-13-24.pdf
... copyrighted by the American Medical Association (AMA) and the American Dental Association (ADA), respectively, all rights reserved. CPT is a registered trademark  ...
Terms matched: 1  -  Score: 31  -  24 Aug 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentB_12-13-24.pdf
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