Nevada Medicaid and Nevada Check Up News (Fourth 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 February 2026 Professional Claims. See Web Announcement 3863.

Top Prior Authorization Denial Reasons for the Fourth Quarter of 2025. See Web Announcement 3830.

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
... REMARK_CODE REMARK_CODE_DESCRIPTION 2603 LOCK-IN VIOLATION 2730 The client is in the Locked-in program. The Lock- 16 Claim/service lacks information or has M62 Missing/incomplete/ ...
Terms matched: 1  -  Score: 11  -  09 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
2. NV_BillingGuidelines_PT17_Specialty_181_20260102.pdf
... facility’s telecommunication system, or the telecommunication system used is a recipient's smart phone or home computer, the facility fee may not be billed. Telehealth ...
Terms matched: 1  -  Score: 20  -  06 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT17_Specialty_181_20260102.pdf
3. Provider_Enrollment_Information_Booklet.pdf
... . It is strongly recommended to have a separate NPI for each location for the best billing and enrollment practices. There are two types of healthcare provider NPI numbers ...
Terms matched: 1  -  Score: 14  -  27 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
4. NV_Billing_General_20260101.pdf
... 1200 discusses requirements for drug prior authorizations. Submission deadlines In general, it is best to submit a request as soon as you know there is a need. ...
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.pdf
... 1200 discusses requirements for drug prior authorizations. Submission deadlines In general, it is best to submit a request as soon as you know there is a need. ...
Terms matched: 1  -  Score: 11  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
6. NV_EVS_User_Manual_Ch1.pdf
... Home page to open the Registration Selector. 1 2. Select the option that best describes your role, such as Provider or Delegate. For this example, ...
Terms matched: 1  -  Score: 28  -  18 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch1.pdf
7. NV_Flex_User_Guide_Getting_Started.pdf
... an error message will display. After three failed attempts, the account will be locked for 20 minutes. Updated 02/18/2026 Page 28 of 45 ...
Terms matched: 1  -  Score: 12  -  18 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Flex_User_Guide_Getting_Started.pdf
8. NV_EnrollmentChecklist_PT17_Spec188_Flex.pdf
... revalidation request.) I attest that the information provided below is accurate to the best of my knowledge. I understand that further documentation may be requested to verify ...
Terms matched: 1  -  Score: 20  -  24 Jan 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EnrollmentChecklist_PT17_Spec188_Flex.pdf
9. NV_EnrollmentChecklist_PT17-188.pdf
... revalidation request.) I attest that the information provided below is accurate to the best of my knowledge. I understand that further documentation may be requested to verify ...
Terms matched: 1  -  Score: 20  -  24 Jan 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EnrollmentChecklist_PT17-188.pdf
10. NV_Billing_General_20251215.pdf
... 1200 discusses requirements for drug prior authorizations. Submission deadlines In general, it is best to submit a request as soon as you know there is a need. ...
Terms matched: 1  -  Score: 11  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20251215.pdf
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