Nevada Medicaid and Nevada Check Up News (First 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]

Notifications

NOTIFICATION: The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. Pacific Time on Monday, May 11, 2026, through 4 a.m. Pacific Time on Tuesday, May 12, 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)
  • Known System Issues-Click HERE

    Top 10 Claim Denial Reasons and Resolutions/Workarounds for March 2026 Professional Claims. See Web Announcement 3894.

    Top Prior Authorization Denial Reasons for the First Quarter of 2026. See Web Announcement 3900.

    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.

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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... allowed per lifetime) when the service is rendered for the same tooth numbers. 90 Claims Some claims submitted between 6/7 /19 and • ...
Terms matched: 1  -  Score: 11  -  06 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
... REASON_CODE_DESCRIPTION REMARK_CODE REMARK_CODE_DESCRIPTION 703 BILLING PERIOD EXCEEDS 90 DAYS 703 Billing Period exceeds 90 days ... about restrictions for this service. 5731 200 UNITS ALLOWED PER ROLLING 5731 200 UNITS ...
Terms matched: 2  -  Score: 174  -  06 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
... request must be submitted no later than 90 calendar days after the newborn is assigned ... Medicaid Services Manual (MSM) Chapters 200 and 400 for additional policy and guidelines ...
Terms matched: 2  -  Score: 107  -  01 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT11.pdf
... request must be submitted no later than 90 calendar days after the newborn is assigned ... Medicaid Services Manual (MSM) Chapters 200 and 400 for additional policy and guidelines ...
Terms matched: 2  -  Score: 107  -  01 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT11_online_082725.pdf
... OF THE MEDICAID INSPECTOR GENERAL Stacie Weeks, Director 9850 Double R Blvd, Suite 200 Cynthia Leech, Administrator Joe Lombardo Reno, Nevada 89521 Governor NVHA.NV.GOV Enrollment Moratorium ...
Terms matched: 1  -  Score: 41  -  30 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/DME_Enrollment_Moratorium_Exemption_Request.pdf
... Medicaid Mental Health Services. After the initial screening, student must be re-screened every 90 calendar days to reevaluate their intensity of needs (Level of Care) . ...
Terms matched: 1  -  Score: 50  -  29 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60_2025-1216.pdf
... Medicaid Mental Health Services. After the initial screening, student must be re-screened every 90 calendar days to reevaluate their intensity of needs (Level of Care) . ...
Terms matched: 1  -  Score: 50  -  29 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60.pdf
... Worker Doula Services Specialty type codes: 90 • 890: Doula ( ... (EVV Required) • 200: Environmental Accessibility Adaptations • ...
Terms matched: 2  -  Score: 126  -  21 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
... A, Policy #6-06. A 90- day global period applies to implantation ... 3 yrs A4287 Disposable collection and storage 200 units per 30 rolling days bag for ...
Terms matched: 2  -  Score: 23  -  03 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT20-24-77.pdf
... A, Policy #6-06. A 90- day global period applies to implantation ... 3 yrs A4287 Disposable collection and storage 200 units per 30 rolling days bag for ...
Terms matched: 2  -  Score: 23  -  03 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT20-24-77_online_011226_to_040326.pdf
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