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 4053.

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. Error_Code_to_EOB_to_ANSI.pdf
... Payment Information REF), if present. 376 4TH OTHER ICD PROCEDURE DATE MISSING 1305 The 4th Other ICD Procedure date is missing or 16 Claim/service lacks ...
Terms matched: 1  -  Score: 24  -  06 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
2. Encounter_NET_837P_Companion_Guide_-_Mod.pdf
... , DN, HN, JN, PN, ED, EH, EJ, EP, DE, HE, Updated 08/04/2026 21 pv( ...
Terms matched: 1  -  Score: 108  -  04 Aug 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Encounter_NET_837P_Companion_Guide_-_Mod.pdf
3. NV_BillingGuidelines_PT60.pdf
... Physician, team member service CO Outpatient Occupational Therapy Assistant CQ Outpatient Physical Therapy Assistant EP Routine Healthy Kids Screening GN Outpatient Speech Language GO Outpatient Occupational Therapy Updated 07 ...
Terms matched: 1  -  Score: 149  -  28 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60.pdf
4. NV_BillingGuidelines_PT20-24-77.pdf
... individual. Additional specifications are listed in the table below. Code Modifier Description 99381 EP or TS New patient, infant (age under 1 year) 99382 EP ...
Terms matched: 1  -  Score: 106  -  28 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT20-24-77.pdf
5. NV_BillingGuidelines_PT32_Spec_932.pdf
... accident/acute event • RR - Residence to Residence • EP - Residential, domiciliary, custodial facility to a physician’s office ...
Terms matched: 1  -  Score: 20  -  28 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT32_Spec_932.pdf
6. NV_BillingGuidelines_PT60_2026-0429.pdf
... Physician, team member service CO Outpatient Occupational Therapy Assistant CQ Outpatient Physical Therapy Assistant EP Routine Healthy Kids Screening GN Outpatient Speech Language GO Outpatient Occupational Therapy Updated 04 ...
Terms matched: 1  -  Score: 149  -  19 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60_2026-0429.pdf
7. 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
8. NV_BillingGuidelines_PT60_2025-1216.pdf
... Physician, team member service CO Outpatient Occupational Therapy Assistant CQ Outpatient Physical Therapy Assistant EP Routine Healthy Kids Screening GN Outpatient Speech Language GO Outpatient Occupational Therapy Updated 12 ...
Terms matched: 1  -  Score: 149  -  29 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60_2025-1216.pdf
9. NV_BillingGuidelines_PT20-24-77_online_011226_to_040326.pdf
... individual. Additional specifications are listed in the table below. Code Modifier Description 99381 EP or TS New patient, infant (age under 1 year) Updated 01 ...
Terms matched: 1  -  Score: 106  -  03 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT20-24-77_online_011226_to_040326.pdf
10. NV_BillingGuidelines_PT20-24-77_online_101325_to_011226.pdf
... individual. Additional specifications are listed in the table below. Code Modifier Description 99381 EP or TS New patient, infant (age under 1 year) 99382 EP ...
Terms matched: 1  -  Score: 106  -  12 Jan 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT20-24-77_online_101325_to_011226.pdf
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