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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Top 10 Claim Denial Reasons and Resolutions/Workarounds for April 2026 Professional Claims. See Web Announcement 3915.

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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1. PT_34_Therapy_Tip_Sheet.pdf
... Authorization Nevada Medicaid Criteria YouTube: PA Search Overview Provider Day Calculator Web Portal Fee WA 1728 Schedule (FA-7 Search Information) Nevada WA 3609 Medicaid (Medical Record ...
Terms matched: 1  -  Score: 35  -  12 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PT_34_Therapy_Tip_Sheet.pdf
2. Error_Code_to_EOB_to_ANSI.pdf
... Policy Identification Segment (loop 2110 Service Payment Information REF), if present. 220 QUANTITY DISPENSED IS INVALID 224 Quantity dispensed is invalid. 16 Claim/service ...
Terms matched: 1  -  Score: 28  -  06 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
3. NV_BillingGuidelines_PT11.pdf
... ://www.medicaid.nv.gov/hcp/provider/Resources/SearchProviders/tabid/220/Default.aspx Reminders for providers who submit institutional claims: • If ...
Terms matched: 1  -  Score: 12  -  01 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT11.pdf
4. NV_BillingGuidelines_PT11_online_082725.pdf
... ://www.medicaid.nv.gov/hcp/provider/Resources/SearchProviders/tabid/220/Default.aspx Reminders for providers who submit institutional claims: • If ...
Terms matched: 1  -  Score: 12  -  01 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT11_online_082725.pdf
5. NV_BillingGuidelines_PT60_2025-1216.pdf
... ://www.medicaid.nv.gov/hcp/provider/Resources/SearchProviders/tabid/220/Default.aspx. For detailed information on Electronic Claims submission refer to the 837P ...
Terms matched: 1  -  Score: 14  -  29 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60_2025-1216.pdf
6. NV_BillingGuidelines_PT60.pdf
... ://www.medicaid.nv.gov/hcp/provider/Resources/SearchProviders/tabid/220/Default.aspx. For detailed information on Electronic Claims submission refer to the 837P ...
Terms matched: 1  -  Score: 14  -  29 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60.pdf
7. NV_BillingGuidelines_PT65_online_20230126.pdf
... ://www.medicaid.nv.gov/hcp/provider/Resources/SearchProviders/tabid/220/Default.aspx Reminders for providers who submit institutional claims: • If ...
Terms matched: 1  -  Score: 20  -  20 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT65_online_20230126.pdf
8. NV_BillingGuidelines_PT65.pdf
... ://www.medicaid.nv.gov/hcp/provider/Resources/SearchProviders/tabid/220/Default.aspx Reminders for providers who submit institutional claims: • If ...
Terms matched: 1  -  Score: 20  -  20 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT65.pdf
9. NV_BillingGuidelines_PT43.pdf
... ://www.medicaid.nv.gov/hcp/provider/Resources/SearchProviders/tabid/220/Default.aspx Electronic Claims instructions: When reporting the provider who ordered services such ...
Terms matched: 1  -  Score: 20  -  25 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT43.pdf
10. NV_BillingGuidelines_PT43_20251118.pdf
... ://www.medicaid.nv.gov/hcp/provider/Resources/SearchProviders/tabid/220/Default.aspx Electronic Claims instructions: When reporting the provider who ordered services such ...
Terms matched: 1  -  Score: 20  -  25 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT43_20251118.pdf
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