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]

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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.

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1. FA-11.pdf
... contractual terms, limitations, exclusions, coordination of benefits and other terms and conditions set forth by the benefit program. The information contained in this form, including ...
Terms matched: 1  -  Score: 26  -  15 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-11.pdf
2. FA-11B.pdf
... contractual terms, limitations, exclusions, coordination of benefits and other terms and conditions set forth by the benefit program. The information contained in this form, including ...
Terms matched: 1  -  Score: 20  -  15 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-11B.pdf
3. NV_BillingGuidelines_PT33_20250623.pdf
... contractual terms, limitations, exclusions, coordination of benefits and other terms and conditions set forth by the benefit program. DME Rent-to-Purchase Option Items identified in the DMEPOS ...
Terms matched: 1  -  Score: 106  -  15 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT33_20250623.pdf
4. NV_BillingGuidelines_PT33.pdf
... contractual terms, limitations, exclusions, coordination of benefits and other terms and conditions set forth by the benefit program. DME Rent-to-Purchase Option Items identified in the DMEPOS ...
Terms matched: 1  -  Score: 106  -  15 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT33.pdf
5. NV_Billing_General.pdf
... /Recipient files Provider Each provider is responsible for: • Following regulations set forth in the Medicaid Services Manual (see Medicaid Services Manual (MSM) ...
Terms matched: 1  -  Score: 94  -  15 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
6. Error_Code_to_EOB_to_ANSI.pdf
... PLEASE CONTACT THE occurrence has been reached. made for same/similar procedure within set CARE COORDINATOR time frame. Updated: 12/08/2025 Page 134 ...
Terms matched: 1  -  Score: 311  -  09 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
7. NV_Enrollment_AnnualAttestation_PT63.pdf
... notified if there is a belief the facility is out of compliance with the requirements set forth in the Psych under 21 rule Updated 12/02/2025 Page ...
Terms matched: 1  -  Score: 66  -  02 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Enrollment_AnnualAttestation_PT63.pdf
8. FA-11E.pdf
... ,communication, interaction with peers or others in the environment or adjustment to the settings in which the recipient’s functions have diminished and update the anticipated ...
Terms matched: 1  -  Score: 58  -  02 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-11E.pdf
9. FA-11E-I.pdf
... or interaction with people in the recipient’s environment or adjustment to the settings in which their functions have diminished. • Target Behavior - Start ...
Terms matched: 1  -  Score: 20  -  02 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-11E-I.pdf
10. Known_Issues.pdf
... without using the copy System.NullReferenceException: Object functionality, until a resolution is reference not set to an instance of an object in place. 10 Web Portal, The ...
Terms matched: 1  -  Score: 14  -  26 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
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