Nevada Medicaid and Nevada Check Up News (First 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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Top 10 Claim Denial Reasons and Resolutions/Workarounds for April 2026 Professional Claims. See Web Announcement 3915.

Top Prior Authorization Denial Reasons for the First Quarter of 2026. See Web Announcement 3900.

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. PT_34_Therapy_Tip_Sheet.pdf
... Authorization Nevada Medicaid Criteria YouTube: PA Search Overview Provider Day Calculator Web Portal Fee WA 1728 Schedule (FA-7 Search Information) Nevada WA 3609 Medicaid (Medical Record ...
Terms matched: 1  -  Score: 35  -  12 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PT_34_Therapy_Tip_Sheet.pdf
2. Error_Code_to_EOB_to_ANSI.pdf
... REMARK_CODE_DESCRIPTION 247 MAXIMUM NUMBER OF CLAIM DETAILS 5310 The detail lines are missing or the ... 730 DAYS 5581 ONE UNIT ALLOWED PER SEVEN 119 Benefit maximum for this time period ...
Terms matched: 2  -  Score: 42  -  06 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
3. NV_Billing_General.pdf
... 02/20/2026 Billing Manual Pv01/01/2026 20 At least seven business days prior to service: • PASRR Level I Evaluation At ...
Terms matched: 1  -  Score: 11  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
4. NV_Billing_General_20260101.pdf
... ¢ Complex Dental Services • Initial Psychiatric Residential Treatment Facility Evaluation At least seven business days prior to service: • PASRR Level I Evaluation At ...
Terms matched: 1  -  Score: 11  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20260101.pdf
5. NV_Billing_General_20251215.pdf
... ¢ Complex Dental Services • Initial Psychiatric Residential Treatment Facility Evaluation At least seven business days prior to service: • PASRR Level I Evaluation At ...
Terms matched: 1  -  Score: 11  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20251215.pdf
6. NV_Billing_General_20251017.pdf
... ¢ Complex Dental Services • Initial Psychiatric Residential Treatment Facility Evaluation At least seven business days prior to service: • PASRR Level I Evaluation At ...
Terms matched: 1  -  Score: 11  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20251017.pdf
7. Benefit_Enrollment_and_Maintenance_(834).pdf
... Companion Guide: Benefit Enrollment and Maintenance (834) • Health Level Seven (HL7): HL7 is one of several ANSI-accredited Standards Development Organizations ( ...
Terms matched: 1  -  Score: 23  -  20 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Benefit_Enrollment_and_Maintenance_(834).pdf
8. NV_Billing_General_20250801.pdf
... ¢ Complex Dental Services • Initial Psychiatric Residential Treatment Facility Evaluation At least seven business days prior to service: • PASRR Level I Evaluation At ...
Terms matched: 1  -  Score: 11  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20250801.pdf
9. NV_EVS_User_Manual_Ch7.pdf
... Provider Web Portal (PWP) User Manual Chapter Seven: Search Provider PWP User Manual, Chapter 7 Updated 10/17/2025 (pv09/30 ...
Terms matched: 1  -  Score: 26  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch7.pdf
10. NV_Billing_General_20250220.pdf
... ¢ Complex Dental Services • Initial Psychiatric Residential Treatment Facility Evaluation At least seven business days prior to service: • PASRR Level I Evaluation At ...
Terms matched: 1  -  Score: 11  -  29 Jul 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20250220.pdf
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