Nevada Medicaid and Nevada Check Up News (Third 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]

Notifications

Provider Flex is now LIVE for all provider types!
For information and training opportunities on this exciting new enrollment tool, please visit our Provider Flex page

Multi-Factor Authentication Frequently Asked Questions

Known System Issues-Click HERE

Top 10 Claim Denial Reasons and Resolutions/Workarounds for November 2025 Professional Claims. See Web Announcement 3789.

Top Prior Authorization Denial Reasons for the Third Quarter of 2025. See Web Announcement 3758.

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.

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

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... PRIVATE INSURANCE per coordination of benefits. Updated: 12/08/2025 Page 120 of 229 Claim Error/EOB/ANSI Code Crosswalk ERROR_CODE ERROR_CODE_DESCRIPTION EOB_CODE EOB_CODE_DESCRIPTION ...
Terms matched: 1  -  Score: 38  -  09 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
... Resolution/Work Around Date Date Recycle Date # Reported Resolved (If Applicable) 120 Claims, Some claims submitted by Provider Type 14- • Provider ...
Terms matched: 1  -  Score: 11  -  26 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
... • 119: Head/Neck Surgery Rare Diseases Clinic • 120: Hematology • 820: Physician, M.D., †...
Terms matched: 1  -  Score: 26  -  05 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
... Event Calendar will show information up to 30 days into the past and up to 120 days into the future. 1. Navigate back and forth between the months ...
Terms matched: 1  -  Score: 14  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch1.pdf
... ), Nevada Medicaid Place of Meeting: Nevada Medicaid 1919 College Parkway, Suite 120 Carson City, Nevada 89706 Please use the teleconference/Microsoft Teams options provided ...
Terms matched: 1  -  Score: 47  -  04 Sep 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3711_20250904.pdf
... continue services. This period combined with the initial authorization period may be up to 120 days total. Updated 03/18/2025 Provider Type 29 Billing Guide ...
Terms matched: 1  -  Score: 41  -  09 Jul 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT29_online_20250318.pdf
... continue services. This period combined with the initial authorization period may be up to 120 days total. Updated 07/09/2025 Provider Type 29 Billing Guide ...
Terms matched: 1  -  Score: 41  -  09 Jul 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT29.pdf
... continue services. This period combined with the initial authorization period may be up to 120 days total. Updated 04/11/2024 Provider Type 29 Billing Guide ...
Terms matched: 1  -  Score: 41  -  18 Mar 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT29_online_20240411.pdf
... to the revalidation due date. Provider revalidation notices are emailed and mailed to providers 120, 90, 60 and 20 days prior to their revalidation due date. ...
Terms matched: 1  -  Score: 31  -  14 Mar 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Provider_Enrollment_Information_Booklet.pdf
... provider website For more information about PT 93, see the following web announcements (WA): • WA 3383 • WA 3452 †...
Terms matched: 1  -  Score: 124  -  20 Feb 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3560_20250220.pdf
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