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]

Notifications

Provider Flex is now LIVE for all provider types!
For information and training opportunities on this exciting new enrollment tool, please visit our Provider Flex page

Multi-Factor Authentication Frequently Asked Questions

Known System Issues-Click HERE

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.

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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... submission/billing error(s ) . Usage: Do not use provider/supplier primary identifier. this code for claims attachment(s )/ other documentation ...
Terms matched: 1  -  Score: 163  -  09 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
... €¢ as a Medical Device, Equipment and Gases Equipment, (MDEG) Supplier OR 33 933 • as a Pharmacy (Exception to MDEG licensure ...
Terms matched: 1  -  Score: 11  -  05 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
... of the disclosing entity. A disclosing entity is defined as a Medicare provider or supplier, or other entity that furnishes services or arranges for furnishing services under Medicaid ...
Terms matched: 1  -  Score: 25  -  21 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Flex_User_Guide_Individual.pdf
... of the disclosing entity. A disclosing entity is defined as a Medicare provider or supplier, or other entity that furnishes services or arranges for furnishing services under Medicaid ...
Terms matched: 1  -  Score: 24  -  21 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Flex_User_Guide_Group.pdf
... is an entity that creates software used by billing services, clearinghouses and providers/suppliers to conduct the exchange of electronic transactions. o Billing service is a third ...
Terms matched: 1  -  Score: 12  -  20 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Benefit_Enrollment_and_Maintenance_(834).pdf
... (5 ) years, with the exception of Durable Medical Equipment (DME) suppliers which must revalidate every three (3 ) years per 42 CFR 424.57. ...
Terms matched: 1  -  Score: 25  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20250801.pdf
... of Durable Medical Equipment, Prosthetics, Orthotics and Disposable Medical Supplies (DMEPOS) suppliers who must revalidate every three (3 ) years per 42 CFR 424.57. ...
Terms matched: 1  -  Score: 25  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
... (5 ) years, with the exception of Durable Medical Equipment (DME) suppliers which must revalidate every three (3 ) years per 42 CFR 424.57. ...
Terms matched: 1  -  Score: 25  -  29 Jul 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20250220.pdf
... medical necessity of Pediatric Specialty Care Services (attach supporting documentation): Screener Certification Supplier Of Information By checking the box below, I certify that I have completed ...
Terms matched: 1  -  Score: 20  -  16 Jul 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-19.pdf
... : 1. In an emergency situation, when an order is received by the supplier after the Quality Improvement Organization (QIO) -like vendor’s ...
Terms matched: 1  -  Score: 59  -  23 Jun 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT33_20240523.pdf
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