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]

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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.

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1. NV_BillingGuidelines_PT17_Specialty_181_20260102.pdf
... 02/2026 Provider Type 17 Specialty 181 Billing Guide (pv08/11/2025) 1/5 Provider Type 17 Specialty 181 Billing Guide Special Clinics: ...
Terms matched: 1  -  Score: 111  -  06 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT17_Specialty_181_20260102.pdf
2. NV_BillingGuidelines_PT17_Spec181.pdf
... (FQHC) • Non-dental services rendered on or before December 31, 2025. General information can be found on the WRAP Supplemental Payment Program webpage. ...
Terms matched: 1  -  Score: 20  -  06 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT17_Spec181.pdf
3. ABA_FAQ.pdf
... being submitted. • For any diagnosis prior to 8/1 /2025, the most updated form must be used. How do we upload the ...
Terms matched: 1  -  Score: 20  -  03 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/ABA_FAQ.pdf
4. FA-1D.pdf
... Page 1 of 3 02/23/2026 (pv 04/24/2025) Nevada Medicaid and Nevada Check Up Wheelchair Repair/Modification Form Recipient Name ...
Terms matched: 1  -  Score: 54  -  23 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-1D.pdf
5. NV_Billing_General_20260101.pdf
... and 5. Updated 01/01/2026 Billing Manual Pv12/15/2025 i Date (mm/dd/yyyy) Description of changes Pages impacted ...
Terms matched: 1  -  Score: 365  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20260101.pdf
6. NV_Billing_General.pdf
... Pharmacy section to update Magellan to Prime Chapter 2 Therapeutics. 02/05/2025 Updated Adjustments and Voids section. Chapter 8 02/20/2025 Removed ...
Terms matched: 1  -  Score: 66  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
7. NV_Flex_User_Guide_Getting_Started.pdf
... €Updated 02/18/2026 Page 1 of 45 pv09/02/2025 2. Hover over the “Providersâ€tab. 3. Select ...
Terms matched: 1  -  Score: 286  -  18 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Flex_User_Guide_Getting_Started.pdf
8. NV_BillingGuidelines_PT85_Spec320.pdf
... This is effective on claims with dates of service on or after October 1, 2025. The Eligibility Checklist is located next to this Billing Guide on the Providers ...
Terms matched: 1  -  Score: 20  -  18 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT85_Spec320.pdf
9. Known_Issues.pdf
... PA) units • Provider: No additional action 10/03/2025 12/15/2025 TBD Authorization equivalent to the allowed quantity submitted on ...
Terms matched: 1  -  Score: 272  -  17 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
10. NV_EVS_User_Manual_Ch3.pdf
... , Chapter 3 Updated 02/17/2026 (pv 10/17/2025) Table of Contents 3.1 Submit Claim .... 1 3.1.1 Submit Claim Dental ...
Terms matched: 1  -  Score: 31  -  17 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch3.pdf
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