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:
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    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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1. NV_BillingGuidelines_PT22-attachmentA.pdf
... service as D7320 for the same quadrant. D7410 RAD EXC LESION UP TO 1.25 CM 00 NC NC D7411 EXCISION BENIGN LESION>1.25C 00 NC NC D7412 EXCISION ...
Terms matched: 1  -  Score: 66  -  23 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentA.pdf
2. NV_BillingGuidelines_PT22-attachmentA_01-29-26.pdf
... service as D7320 for the same quadrant. D7410 RAD EXC LESION UP TO 1.25 CM 00 NC NC D7411 EXCISION BENIGN LESION>1.25C 00 NC NC D7412 EXCISION ...
Terms matched: 1  -  Score: 66  -  23 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentA_01-29-26.pdf
3. NV_BillingGuidelines_PT22-attachmentB_01-29-26.pdf
... part of another procedure 00 tissue D7910 Suture of recent small wounds up to 5 cm 00 None D7961 Buccal / Labial Frenectomy (Frenulectomy) 00 Three in a ...
Terms matched: 1  -  Score: 12  -  02 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentB_01-29-26.pdf
4. NV_BillingGuidelines_PT22-attachmentB.pdf
... part of another procedure 00 tissue D7910 Suture of recent small wounds up to 5 cm 00 None D7961 Buccal / Labial Frenectomy (Frenulectomy) 00 Three in a ...
Terms matched: 1  -  Score: 12  -  02 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentB.pdf
5. NV_BillingGuidelines_PT22-attachmentB_12-08-25.pdf
... part of another procedure 00 tissue D7910 Suture of recent small wounds up to 5 cm 00 None D7961 Buccal / Labial Frenectomy (Frenulectomy) 00 Three in a ...
Terms matched: 1  -  Score: 12  -  15 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentB_12-08-25.pdf
6. NV_BillingGuidelines_PT22-attachmentB_10-06-25.pdf
... part of another procedure 00 tissue D7910 Suture of recent small wounds up to 5 cm 00 None D7961 Buccal / Labial Frenectomy (Frenulectomy) 00 Three in a ...
Terms matched: 1  -  Score: 12  -  08 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentB_10-06-25.pdf
7. FA-16A.pdf
... /ulcer with an arrow or an “Xâ€Wound Measurements (in cm): Length: ___ cm Width: ___ cm Depth: ___ cm ...
Terms matched: 1  -  Score: 93  -  22 Jul 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-16A.pdf
8. web_announcement_3560_20250220.pdf
... provider website For more information about PT 93, see the following web announcements (WA): • WA 3383 • WA 3452 †...
Terms matched: 1  -  Score: 124  -  20 Feb 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3560_20250220.pdf
9. web_announcement_3543_20250129.pdf
... Procedure Code Description 15271 Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms or legs 15272 Application of skin substitute (wound ...
Terms matched: 1  -  Score: 117  -  29 Jan 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3543_20250129.pdf
10. Inflammatory_Bowel_Disease_Agents_2017-09.pdf
... to moderate ï - (UCERIS - - - distal UC extending up to 40 cm rectal foam) from the anal verge Maintenance of remission of UC ï in ...
Terms matched: 1  -  Score: 28  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Inflammatory_Bowel_Disease_Agents_2017-09.pdf
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