Nevada Medicaid and Nevada Check Up News (Fourth 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]

Notifications

Known System Issues-Click HERE

Top 10 Claim Denial Reasons and Resolutions/Workarounds for February 2026 Professional Claims. See Web Announcement 3863.

Top Prior Authorization Denial Reasons for the Fourth Quarter of 2025. See Web Announcement 3830.

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.

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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... REMARK_CODE REMARK_CODE_DESCRIPTION 2603 LOCK-IN VIOLATION 2730 The client is in the Locked-in program. The Lock- 16 Claim/service lacks information or has M62 Missing/incomplete/ ...
Terms matched: 1  -  Score: 11  -  09 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.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
... Table 1: Nevada Medicaid Provider Types and Specialties .... 2 Enrollment Types and Key Enrollment Requirements .... 11 Application Types .... 14 Table 2: Application ...
Terms matched: 1  -  Score: 127  -  27 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
... on the U.S. Department of Health and Human Services website on the Grant Programs Key Resources for Title X Grantees webpage. Instructions for Completing Form HHS-687 †...
Terms matched: 1  -  Score: 11  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
... on the U.S. Department of Health and Human Services website on the Grant Programs Key Resources for Title X Grantees webpage. Instructions for Completing Form HHS-687 †...
Terms matched: 1  -  Score: 11  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20260101.pdf
... hyperlink provides assistance when you have forgotten your registered User ID. Upon verification of key identifiers on the portal security directory, an email is sent to the email ...
Terms matched: 1  -  Score: 24  -  18 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch1.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
... Office or other outpatient visit for Typically, 20 minutes Physician or Requires these three key components: an No All Levels the evaluation and management of a are spent ...
Terms matched: 1  -  Score: 38  -  14 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT14_online_011226.pdf
... Office or other outpatient visit Typically, 20 minutes Physician or other Requires these three key components: an No All Levels for the evaluation and are spent face-to-face qualified ...
Terms matched: 1  -  Score: 38  -  14 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT14.pdf
... Office or other outpatient visit for Typically, 20 minutes Physician or Requires these three key components: an No All Levels the evaluation and management of a are spent ...
Terms matched: 1  -  Score: 42  -  12 Jan 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT14_online_030525.pdf
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