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. EVS_FAQ.pdf
... /evsusermanual.aspx. viewing Claim submissions? Are there any additional Yes. The training materials can be located on the Provider Training webpage at: training materials that I ...
Terms matched: 1  -  Score: 132  -  23 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/EVS_FAQ.pdf
2. 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
3. web_announcement_4015_20260923.pdf
... a delegate for any providers whom you service. Please review the following available training materials to prepare for MFA: • PWP User Manual, Chapter 1 ...
Terms matched: 1  -  Score: 20  -  24 Sep 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_4015_20260923.pdf
4. Trading_Partner_Agreement.pdf
... immediately terminate this agreement if the Trading Partner fails to comply with or violates a material provision of this agreement. Miscellaneous This agreement shall be interpreted consistently with all ...
Terms matched: 1  -  Score: 20  -  17 Sep 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Trading_Partner_Agreement.pdf
5. Known_Issues.pdf
... or vacuum, with or automatically reprocessed. without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, ...
Terms matched: 1  -  Score: 11  -  01 Sep 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
6. NV_BillingGuidelines_PT22-attachmentB_12-13-24.pdf
... 00 1 unit per 60 months with resin denture bases (including retentive/clasping materials, rests and teeth) D5214 Mandibular partial denture - cast metal 00 1 ...
Terms matched: 1  -  Score: 51  -  24 Aug 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentB_12-13-24.pdf
7. NV_BillingGuidelines_PT22-attachmentB_03-27-23.pdf
... denture, resin base (including 00 1 unit per 60 months retentive/clasping materials, rests and teeth) D5212 Mandibular partial denture, resin base (including ...
Terms matched: 1  -  Score: 34  -  24 Aug 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentB_03-27-23.pdf
8. FAQ_PASRR_and_NF_LOC.pdf
... LOC & Nursing Facility Provider Training presentation located on the Provider Training webpage under Workshop Materials. Updated 08/11/2026 (pv05/23/2024) ...
Terms matched: 1  -  Score: 21  -  11 Aug 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FAQ_PASRR_and_NF_LOC.pdf
9. NV_BillingGuidelines_PT25-41.pdf
... When dispensing optical supplies, specify spectacle services using CPT codes 92340-92371 and supply of materials using HCPCS codes V2100-V2799 (non-covered codes in this range are V2744, V2756 ...
Terms matched: 1  -  Score: 36  -  28 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT25-41.pdf
10. NV_BillingGuidelines_PT60.pdf
... • Once in a lifetime per tooth D2980 Crown repair necessitated by restorative material failure. • Once in a lifetime per tooth Endodontics (D3110-D3950 ...
Terms matched: 1  -  Score: 29  -  28 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60.pdf
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