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]

Featured Links

Nevada Medicaid EVV

Authorization Criteria

Nevada Medicaid Home

EDI Information

PWP User Manual

Provider Enrollment

Provider Login (PWP)

Prior Authorization

Search Fee Schedule

Search Providers

Claims

Trading Partner

Self-Paced Training Videos

Notifications

NOTIFICATION:The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. to midnight Pacific Time on Sunday, August 30, 2026, for scheduled maintenance:
  • All secure Provider Web Portal (PWP) functions
  • Provider Flex
  • Gabby®, which includes:
    • Gainwell Technologies Contact Center (877) 638-3472
    • Automated Response System (ARS) (800) 942-6511
  • Real time CAQH/CORE EDI eligibility and claim verification
  • Provider Pre-Admission Screening Resident Review (PASRR)
  • Trading Partner File Transfer (EDI/SFTP)
  • Business Partner File Transfer (EDI/SFTP)

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 July 2026 Professional Claims. See Web Announcement 3983.

Top Prior Authorization Denial Reasons for the Second Quarter of 2026. See Web Announcement 3978.

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.

Provider Links

Nevada Medicaid EVV

Billing Information

Forms

Provider Enrollment

Provider Newsletters

Provider Training

Scheduled Site Maintenance

During the scheduled site maintenance window the Provider Web Portal will be unavailable. The table below shows the regularly scheduled maintenance window. All times will be in the Pacific time zone.

Monday - Friday
12:00AM - 12:30AM

Monday
8:00PM - 12:00AM

Enhance your search:
  • Note that you can use "*" and "?" as wildcards.

  • Enclosing more than one word in double quotes ("search engine") will search for the exact phrase.
Example Zoom search template page

Search this site

Enter one or more keywords to search for using the Zoom Search Engine.
Note that '*' and '?' wildcards are supported.



Match:

Search results for: wa 0821 1305 0400 service niton xrf pmi murah tangerang banten tiga pillar

No results found containing all search terms. 4589 results found containing some search terms.

459 pages of results.
Sort by relevance / Sorted by date ▼
1. NV_BillingGuidelines_PT22-attachmentA.pdf
... Prior authorization is not required for EPSDT/Healthy Kids, adult emergency and palliative services, for a pregnancy related service, and expanded adult services. 01 = ...
Terms matched: 1  -  Score: 547  -  01 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentA.pdf
2. NV_BillingGuidelines_PT22-attachmentA_03-23-26.pdf
... = Prior authorization is not required for EPSDT/Healthy Kids and for adult emergency services. 01 = Prior authorization is required. 02 = Prior authorization is required ...
Terms matched: 1  -  Score: 547  -  01 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentA_03-23-26.pdf
3. NV_BillingGuidelines_PT22.pdf
... Provider Type 22 Billing Guide Dentist Dental Services Program Overview Recipients Age 21 and Older Adult Medicaid recipients may receive the following dental services subject to a $1 ...
Terms matched: 1  -  Score: 404  -  01 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22.pdf
4. NV_BillingGuidelines_PT22_20230327.pdf
... Provider Type 22 Billing Guide Dentist Dental Services Program Overview Recipients age 21 and older may receive emergency extractions, palliative care, and dentures/prosthetic care under ...
Terms matched: 1  -  Score: 378  -  01 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22_20230327.pdf
5. NV_BillingGuidelines_PT17_Spec181.pdf
... Overview Federally Qualified Health Centers (FQHCs) are defined by the Health Resources and Services Administration (HRSA) as health centers providing comprehensive primary and preventive healthcare to ...
Terms matched: 1  -  Score: 419  -  01 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT17_Spec181.pdf
6. NV_BillingGuidelines_PT17_Specialty_181_20260306.pdf
... Overview Federally Qualified Health Centers (FQHCs) are defined by the Health Resources and Services Administration (HRSA) as health centers providing comprehensive primary and preventive healthcare to ...
Terms matched: 1  -  Score: 408  -  01 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT17_Specialty_181_20260306.pdf
7. NV_BillingGuidelines_PT34.pdf
... Provider Type 34 Billing Guide Therapy Where to find state policy The Medicaid Services Manual (MSM) Chapter 1700 contains State policy for all therapy services, including ...
Terms matched: 1  -  Score: 313  -  02 Jun 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT34.pdf
8. NV_BillingGuidelines_PT34_2026-0101.pdf
... Provider Type 34 Billing Guide Therapy Where to find state policy The Medicaid Services Manual (MSM) Chapter 1700 contains State policy for all therapy services, including ...
Terms matched: 1  -  Score: 305  -  02 Jun 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT34_2026-0101.pdf
9. NV_BillingGuidelines_PT60_2026-0429.pdf
... Provider Type 60 Billing Guide School Health Services (SHS) Table of Contents Program Overview .... 2 Student Requirements .... 2 State Policy .... 2 ...
Terms matched: 1  -  Score: 547  -  19 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60_2026-0429.pdf
10. NV_BillingGuidelines_PT60.pdf
... Provider Type 60 Billing Guide School Health Services (SHS) Table of Contents Program Overview .... 2 Student Requirements .... 2 State Policy .... 2 ...
Terms matched: 1  -  Score: 547  -  19 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60.pdf
Result Pages: 1 2 3 4 5 6 7 8 9 10 11 Next >>

Search powered by Zoom Search Engine



Search took 0.071 seconds