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 ... : 03/09/2026 Page 12 of 180 Claim Error/EOB/ ...
Terms matched: 2  -  Score: 294  -  09 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
2. NV_BillingGuidelines_PT25-41_20241218.pdf
... cost of options. Non-covered options must be listed separately on the invoice. Updated 12/18/2024 Provider Type 25 and 41 Billing Guide Pv09/05 ...
Terms matched: 1  -  Score: 116  -  03 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT25-41_20241218.pdf
3. NV_BillingGuidelines_PT25-41.pdf
... authorization when service limits are exceeded. The service limit for V2624 is once every 12 months per eye per recipient. The service limit for V2628 is once every ...
Terms matched: 1  -  Score: 69  -  03 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT25-41.pdf
4. Provider_Enrollment_Information_Booklet.pdf
... Specialty type code: • 911: Hospital, Inpatient Hospital, Outpatient 12 Specialty type code: • 912: Hospital, Outpatient Psychiatric Hospital ...
Terms matched: 1  -  Score: 97  -  27 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
5. web_announcement_3816_20260112.pdf
... may not bill these codes. See Web Announcement 3847 for more information. January 12, 2026 Nevada Medicaid Web Announcement 3816 Attention Provider Types 24 (Advanced Practice ...
Terms matched: 1  -  Score: 38  -  23 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3816_20260112.pdf
6. NV_Billing_General.pdf
... Chapter 4: Peer-to-Peer Review or Reconsideration for Throughout additional information document Updates made throughout 12/15/2025 Updated title of Medicaid Services Manual Chapter 1300 to Durable ...
Terms matched: 1  -  Score: 47  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
7. NV_Billing_General_20260101.pdf
... Chapter 4: Peer-to-Peer Review or Reconsideration for Throughout additional information document Updates made throughout 12/15/2025 Updated title of Medicaid Services Manual Chapter 1300 to Durable ...
Terms matched: 1  -  Score: 47  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20260101.pdf
8. NV_EVS_User_Manual_Ch1.pdf
... week except during the scheduled weekly maintenance periods, which are Monday through Friday from 12 midnight to 12:30 a.m. Pacific Time (PT) and Monday ...
Terms matched: 1  -  Score: 93  -  18 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch1.pdf
9. NV_Flex_User_Guide_Getting_Started.pdf
... (MFA) .... 7 Log In to Provider Flex with MFA .... 12 1.3. Forgot User ID .... 15 1.4. Forgot Password .... ...
Terms matched: 1  -  Score: 33  -  18 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Flex_User_Guide_Getting_Started.pdf
10. Known_Issues.pdf
... ) units • Provider: No additional action 10/03/2025 12/15/2025 TBD Authorization equivalent to the allowed quantity submitted on the ...
Terms matched: 1  -  Score: 386  -  17 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
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