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]

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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.

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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

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8:00PM - 12:00AM

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1. NV_BillingGuidelines_PT60_2025-1216.pdf
... they may bill HCPCS code Q3014. If the telecommunication system used is a recipient's smart phone or home computer, the facility fee may not be billed. Code ...
Terms matched: 1  -  Score: 10  -  29 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60_2025-1216.pdf
2. NV_BillingGuidelines_PT60.pdf
... they may bill HCPCS code Q3014. If the telecommunication system used is a recipient's smart phone or home computer, the facility fee may not be billed. Code ...
Terms matched: 1  -  Score: 10  -  29 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60.pdf
3. FA-30.pdf
... Wandering Behavior Violent Behavior Danger to Self Danger to Others Other Inappropriate Behaviors Requires a Locked Facility No Appropriate Beds Available In-State Requires Specialty Care (Bariatric, Pediatric, ...
Terms matched: 1  -  Score: 23  -  16 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-30.pdf
4. FA-30-I.pdf
... o Danger to Self o Danger to Others o Other Inappropriate Behaviors o Requires a Locked Facility o No Appropriate Beds Available In-State o Requires Specialty Care (Bariatric, ...
Terms matched: 1  -  Score: 20  -  16 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-30-I.pdf
5. 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
6. 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
7. NV_BillingGuidelines_PT60_2024-0828.pdf
... they may bill HCPCS code Q3014. If the telecommunication system used is a recipient's smart phone or home computer, the facility fee may not be billed. Code ...
Terms matched: 1  -  Score: 10  -  16 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60_2024-0828.pdf
8. web_announcement_3765_20251112.pdf
... ¢ Procedure codes A4420 (Ostomy Pouch, Closed; for use on Barrier with Locking Flange) and A4483 (Moisture Exchanger) no longer require initial prior authorization ...
Terms matched: 1  -  Score: 21  -  12 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3765_20251112.pdf
9. NV_Flex_User_Guide_Group.pdf
... needed, select “Lock Answers & Proceed.â€Once these answers have been locked, this information cannot be changed. The current application will need to be ...
Terms matched: 1  -  Score: 14  -  21 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Flex_User_Guide_Group.pdf
10. NV_Flex_User_Guide_Individual.pdf
... , select “Lock Answers & Proceedâ€. Once these answers have been locked, this information cannot be changed. The current application will need to be ...
Terms matched: 1  -  Score: 14  -  21 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Flex_User_Guide_Individual.pdf
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