Nevada Medicaid and Nevada Check Up News (First 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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NOTIFICATION: The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. Pacific Time on Monday, May 11, 2026, through 4 a.m. Pacific Time on Tuesday, May 12, 2026, for scheduled maintenance:
  • All secure Provider Web Portal (PWP) functions
  • Provider Flex
  • Gabby®, which includes:
    • Gainwell Technologies Contact Center (877) 638-3472
    • Automated Response System (ARS) (800) 942-6511
  • Real time CAQH/CORE EDI eligibility and claim verification
  • Provider Pre-Admission Screening Resident Review (PASRR)
    • Known System Issues-Click HERE

    Top 10 Claim Denial Reasons and Resolutions/Workarounds for March 2026 Professional Claims. See Web Announcement 3894.

    Top Prior Authorization Denial Reasons for the First Quarter of 2026. See Web Announcement 3900.

    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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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

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8:00PM - 12:00AM

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1. Known_Issues.pdf
... Change/Update Change/Update an error on the “Request Informationâ€panel that Application with a letter attached Applications they cannot proceed to complete their indicating ...
Terms matched: 1  -  Score: 14  -  06 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
2. NV_BillingGuidelines_PT43.pdf
... a provider performs all of the constituent procedures of a covered organ or disease oriented panel, the provider must submit a claim for the panel rather than for each ...
Terms matched: 1  -  Score: 80  -  25 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT43.pdf
3. NV_BillingGuidelines_PT43_20251118.pdf
... a provider performs all of the constituent procedures of a covered organ or disease oriented panel, the provider must submit a claim for the panel rather than for each ...
Terms matched: 1  -  Score: 80  -  25 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT43_20251118.pdf
4. NV_Billing_Justice_Initiative.pdf
... years or older 36415 Venipuncture 2 units per day 36416 Capillary blood collection 80061 Lipid panel 83655 Lead testing 85013 Microhematocrit 85018 Hemoglobin 86701 Antibody; HIV-1 86780 Antibody; ...
Terms matched: 1  -  Score: 12  -  18 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_Justice_Initiative.pdf
5. NV_Billing_General_20260101.pdf
... field. All MCO coverage details can be found in the Managed Care Assignment Details panel. Updated 01/01/2026 Billing Manual Pv12/15/2025 ...
Terms matched: 1  -  Score: 11  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20260101.pdf
6. NV_Billing_General.pdf
... field. All MCO coverage details can be found in the Managed Care Assignment Details panel. The PWP User Manual provides additional details on the PWP eligibility request and ...
Terms matched: 1  -  Score: 11  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
7. NV_EVS_User_Manual_Ch3.pdf
... primary, check this box; When this box is checked the Other Insurance Information panel will appear on the Submit Dental Claim: Step 2 • Total ...
Terms matched: 1  -  Score: 316  -  17 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch3.pdf
8. NV_BillingGuidelines_PT34.pdf
... an aerosol generator, nebulizer, metered dose inhaler or IPPB device 94667 Manipulation chest wall, such as cupping, percussing, Required and vibration to facilitate lung function ...
Terms matched: 1  -  Score: 24  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT34.pdf
9. NV_BillingGuidelines_PT34_2023-1121.pdf
... an aerosol generator, nebulizer, metered dose inhaler or IPPB device 94667 Manipulation chest wall, such as cupping, percussing, Required and vibration to facilitate lung function ...
Terms matched: 1  -  Score: 24  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT34_2023-1121.pdf
10. NV_Billing_General_20251017.pdf
... field. All MCO coverage details can be found in the Managed Care Assignment Details panel. Updated 10/17/2025 Billing Manual Pv08/01/2025 ...
Terms matched: 1  -  Score: 11  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20251017.pdf
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