Nevada Medicaid and Nevada Check Up News (Second 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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IMPORTANT: Nevada Medicaid is conducting a swift revalidation effort on high risk providers. If selected, you will receive a revalidation notice with instructions through the standard communication process. See Web Announcement 3935 for more information.

Known System Issues-Click HERE

Top 10 Claim Denial Reasons and Resolutions/Workarounds for July 2026 Professional Claims. See Web Announcement 3983.

Top Prior Authorization Denial Reasons for the Second Quarter of 2026. See Web Announcement 3978.

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. NV_BillingGuidelines_PT22.pdf
... prior authorization request to the review status. Dental Requests • Use the ADA Claim Form and list all dental procedures to be performed. • ...
Terms matched: 1  -  Score: 55  -  01 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22.pdf
2. NV_BillingGuidelines_PT22_20230327.pdf
... prior authorization request to the review status. Dental Requests • Use the ADA Claim Form and list all dental procedures to be performed. • ...
Terms matched: 1  -  Score: 55  -  01 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22_20230327.pdf
3. NV_BillingGuidelines_PT22-attachmentA.pdf
... copyrighted by the American Medical Association (AMA) and the American Dental Association (ADA), respectively, all rights reserved. CPT is a registered trademark  ...
Terms matched: 1  -  Score: 31  -  01 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentA.pdf
4. NV_BillingGuidelines_PT17_Spec181.pdf
... /1 /2026. For all dental services billed using American Dental Association (ADA) “Dâ€codes, submit the 837D electronic transaction. Claims ...
Terms matched: 1  -  Score: 20  -  01 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT17_Spec181.pdf
5. NV_BillingGuidelines_PT17_Specialty_181_20260306.pdf
... /1 /2026. For all dental services billed using American Dental Association (ADA) “Dâ€codes, submit the 837D electronic transaction. Claims ...
Terms matched: 1  -  Score: 20  -  01 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT17_Specialty_181_20260306.pdf
6. 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
7. Error_Code_to_EOB_to_ANSI.pdf
... /incomplete/invalid procedure code(s ) . TERMINATION CMS, AMA or ADA for the Date of Service. submission/billing error(s ) . ...
Terms matched: 1  -  Score: 11  -  06 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
8. NV_BillingGuidelines_PT17_Specialty_181_20260102.pdf
... Claims/EDI webpage. For all dental services billed using American Dental Association (ADA) “Dâ€codes, submit the 837D electronic transaction. Updated ...
Terms matched: 1  -  Score: 20  -  06 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT17_Specialty_181_20260102.pdf
9. NV_Billing_General_20260101.pdf
... by the American Medical Association (AMA), and the American Dental Association (ADA), respectively, all rights reserved. AMA and ADA assume no liability ...
Terms matched: 1  -  Score: 52  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20260101.pdf
10. NV_Billing_General.pdf
... by the American Medical Association (AMA), and the American Dental Association (ADA), respectively, all rights reserved. AMA and ADA assume no liability ...
Terms matched: 1  -  Score: 52  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
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