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 September 2026 Professional Claims. See Web Announcement 4031.

Top Prior Authorization Denial Reasons for the Second Quarter of 2026. See Web Announcement 4053.

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. PASRR_LOC_NF_Training_2021.pdf
... the right side. Nevada Medicaid â€" PASRR / LOC / NF Training 100 Entering Applicant Behavior Issues, Discharge Potential Justification Entering Applicant Behavior Issues, Discharge ...
Terms matched: 1  -  Score: 12  -  27 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PASRR_LOC_NF_Training_2021.pdf
2. TPL_Frequently_Asked_Questions.pdf
... payer of last resort. a recipient has other insurance? Providers should review Chapter 100 of the Medicaid Services Manual and the Billing Manual for more information. It ...
Terms matched: 1  -  Score: 21  -  23 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/TPL_Frequently_Asked_Questions.pdf
3. NV_Billing_General.pdf
... regulations set forth in the Medicaid Services Manual (MSM) (see MSM Chapter 100 Medicaid Program and MSM Chapter 3300 Program Integrity) • Obtaining prior ...
Terms matched: 1  -  Score: 98  -  22 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
4. NV_Billing_General_20261008.pdf
... regulations set forth in the Medicaid Services Manual (MSM) (see MSM Chapter 100 Medicaid Program and MSM Chapter 3300 Program Integrity) • Obtaining prior ...
Terms matched: 1  -  Score: 98  -  22 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20261008.pdf
5. NV_BillingGuidelines_PT22_20260701.pdf
... Health Authority, Nevada Medicaid website at: nevadamedicaid.nv.gov. • MSM Chapter 100 contains important information applicable to all provider types. • MSM Chapter ...
Terms matched: 1  -  Score: 29  -  22 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22_20260701.pdf
6. NV_BillingGuidelines_PT22.pdf
... documents on the Nevada Medicaid website at: nevadamedicaid.nv.gov. • MSM Chapter 100 contains important information applicable to all provider types. • MSM Chapter ...
Terms matched: 1  -  Score: 29  -  22 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22.pdf
7. NV_BillingGuidelines_PT32_Spec_249_online_20260727.pdf
... both Medicare and Medicaid benefits. Please review Medicaid Services Manual (MSM) Chapter 100, Section 104.1 titled “Payment Limits and Exceptionsâ€at Chapter 100 ...
Terms matched: 1  -  Score: 35  -  21 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT32_Spec_249_online_20260727.pdf
8. NV_BillingGuidelines_PT32_Spec_249.pdf
... both Medicare and Medicaid benefits. Please review Medicaid Services Manual (MSM) Chapter 100, Section 104.1 titled “Payment Limits and Exceptionsâ€at Chapter 100 ...
Terms matched: 1  -  Score: 35  -  21 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT32_Spec_249.pdf
9. Provider_Enrollment_Information_Booklet.pdf
... //www.nevadamedicaid.nv.gov/ . MSM Chapter 100 contains specific enrollment requirements. General Information ... Disabilities and Related Conditions • 240: Developmentally Disabled • 242 ...
Terms matched: 2  -  Score: 70  -  19 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
10. NV_BillingGuidelines_PT85_20260727.pdf
... MSM Chapter 400 covers policy for behavioral health providers. • MSM Chapter 100 contains important information applicable to all provider types, including information regarding medical necessity ...
Terms matched: 1  -  Score: 16  -  13 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT85_20260727.pdf
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