Nevada Medicaid and Nevada Check Up News (Third 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 November 2025 Professional Claims. See Web Announcement 3789.

Top Prior Authorization Denial Reasons for the Third Quarter of 2025. See Web Announcement 3758.

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
... MAXIMUM NUMBER OF CLAIM DETAILS 5310 The detail lines are ... , if present. 1062 ORDERING NPI REQUIRED 1062 Ordering ... TERMINATION CMS, AMA or ADA for the Date of ...
Terms matched: 3  -  Score: 228  -  09 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
2. NV_BillingGuidelines_PT22-attachmentB.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  -  08 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentB.pdf
3. NV_BillingGuidelines_PT22-attachmentB_10-06-25.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  -  08 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentB_10-06-25.pdf
4. NV_Enrollment_AnnualAttestation_PT63.pdf
... letter L and is then followed by three digits and is numbered according to the order in which a facility was identified as a PRTF in their State. For ...
Terms matched: 1  -  Score: 20  -  02 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Enrollment_AnnualAttestation_PT63.pdf
5. Known_Issues.pdf
... ) and/or error code 1022-(Referring NPI required) when the ordering NPI is entered appropriately with the “DKâ€qualifier. 84 Claims ...
Terms matched: 1  -  Score: 47  -  26 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
6. web_announcement_3774_20251119.pdf
... dental encounters for FQHCs will be transitioned to billing on the American Dental Association (ADA) form with the encounter code D2999. After this transition, Nevada Medicaid ...
Terms matched: 1  -  Score: 21  -  26 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3774_20251119.pdf
7. New_Provider_Road_Map.pdf
... a new provider. It is recommended to attend the following courses in this suggested order to ensure you get the information and resources you need. Icon Virtual Instructor-Led ...
Terms matched: 1  -  Score: 26  -  21 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/New_Provider_Road_Map.pdf
8. web_announcement_3735_20251002.pdf
... and should be submitted on all regular dental claims in the American Dental Association (ADA) format. The rate for code D2999 will be the same as code ...
Terms matched: 1  -  Score: 20  -  19 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3735_20251002.pdf
9. NV_BillingGuidelines_PT43.pdf
... Chapter 800 for the specific criteria that must be met before the tests can be ordered. • CPT codes for biomarker testing for diagnosis, treatment, ...
Terms matched: 1  -  Score: 198  -  18 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT43.pdf
10. NV_BillingGuidelines_PT43_20250804.pdf
... Chapter 800 for the specific criteria that must be met before the tests can be ordered. • CPT codes for biomarker testing for diagnosis, treatment, ...
Terms matched: 1  -  Score: 198  -  18 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT43_20250804.pdf
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