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]

Notifications

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.

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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... , 8 Updated 10/22/2026 Billing Manual Pv10/08/2026 iii Date (mm/dd/yyyy) Description of changes Pages impacted from ...
Terms matched: 1  -  Score: 24  -  22 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
... Center. Updated 10/08/2026 Billing Manual Pv07/10/2026 iii Date (mm/dd/yyyy) Description of changes Pages impacted 10 ...
Terms matched: 1  -  Score: 28  -  22 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20261008.pdf
... : Address (include city, state, zip): Phone: Fax: III. ICD-10 DIAGNOSIS Primary Code: Disorder: Secondary Code: Disorder: Tertiary ...
Terms matched: 1  -  Score: 23  -  14 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-14.pdf
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... : Is this request for Healthy Kids (EPSDT) services? Yes No SECTION III. RESPONSIBLE PARTY Organization/Legally Responsible Adult Name: Phone: Relationship to ...
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... Code: Disorder: Secondary Code: Disorder: Tertiary Code: Disorder: SECTION III. CURRENT MEDICATION(S ) Current Medications (indicate changes since last report ...
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... the surgery: • The physician who performs the hysterectomy must complete Section III of form FA-50 to indicate that the recipient was already sterile at the time ...
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