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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URGENT NOTIFICATION: Update regarding the Electronic Visit Verification (EVV) claims processing error. Nevada Medicaid did not receive some claims from Sandata (Optum) in time for the February 06, 2026 financial cycle. The issue was resolved this week. EVV providers can contact Sandata Technologies at (833) 545-0394 or support@sandata.com for assistance.

EDI Trading Partners: If you have not already scheduled a migration date for your SFTP connection to the new URL, please contact NV MMIS EDI Support immediately. SFTP services at sftp.medicaid.nv.gov will be discontinued starting January 21, 2026.
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Top 10 Claim Denial Reasons and Resolutions/Workarounds for December 2025 Professional Claims. See Web Announcement 3789.

Top Prior Authorization Denial Reasons for the Fourth Quarter of 2025. See Web Announcement 3830.

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1. 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
2. IBS_and_Constipation_Agents_2018-0613.pdf
... 2 (8 ): 675-82. ï ‚ Lembo A, Pimentel M, Rao SS, et al. Repeat treatment with rifaximin is safe and effective in ...
Terms matched: 1  -  Score: 12  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/IBS_and_Constipation_Agents_2018-0613.pdf
3. HMG_CoA_Reductase_Inhibitors_2013-0812.pdf
... 3 ): 427-37. 104. Crouse JR 3rd, Raichlen JS, Riley WA, Evans GW, Palmer MK, O'Leary DH, et al. Effect ...
Terms matched: 1  -  Score: 10  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/HMG_CoA_Reductase_Inhibitors_2013-0812.pdf
4. HMG CoA Reductase Inhibitors.pdf
... 3 ): 427-37. 104. Crouse JR 3rd, Raichlen JS, Riley WA, Evans GW, Palmer MK, O'Leary DH, et al. Effect ...
Terms matched: 1  -  Score: 10  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/HMG%20CoA%20Reductase%20Inhibitors.pdf
5. E-Binder_PT_September_2018.pdf
... , Raichlen JS, Riley WA, et al. ... trials (total N = 7001) evaluating aclidinium vs ... Domingues et al 2009, Rao et al 2000, ...
Terms matched: 3  -  Score: 54  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_PT_September_2018.pdf
6. E-Binder_September_2015.pdf
... inez MJA, Evers S, Kinge E, Allais G, Allen C, Rao NA, et al. Preference for rizatriptan 10-mg wafer vs eletriptan 40-mg tablet ...
Terms matched: 1  -  Score: 11  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_September_2015.pdf
7. E-Binder_PT_September_2017.pdf
... ) . May 2016. ï ‚ Crouse JR 3rd, Raichlen JS, Riley WA, et al. Effect of rosuvastatin on progression of carotid intima-media thickness in ...
Terms matched: 1  -  Score: 11  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_PT_September_2017.pdf
8. E-Binder_PT_March_2018.pdf
... ) . August 2017. ï ‚ Crouse JR 3rd, Raichlen JS, Riley WA, et al. Effect of rosuvastatin on progression of carotid intima-media thickness in ...
Terms matched: 1  -  Score: 11  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_PT_March_2018.pdf
9. E-Binder_December_2015.pdf
... . 63. Kok RM, Nolen WA, Heeren TJ. Venlafaxine vs nortriptyline ... , Clauw DJ, Gendreau RM, Rao SG, Kranzler J, Chen W ...
Terms matched: 2  -  Score: 48  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_December_2015.pdf
10. Dopamine_Agonists_2013-0812.pdf
... ): 848-56. 43. Hening WA, Allen RP, Ondo WG, ... , Rajput A, Boroojerdi B, Rao J. Randomized, blind, controlled ...
Terms matched: 2  -  Score: 87  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Dopamine_Agonists_2013-0812.pdf
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