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]

Notifications

Known System Issues-Click HERE

Top 10 Claim Denial Reasons and Resolutions/Workarounds for April 2026 Professional Claims. See Web Announcement 3915.

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.

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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... Authorization Nevada Medicaid Criteria YouTube: PA Search Overview Provider Day Calculator Web Portal Fee WA 1728 Schedule (FA-7 Search Information) Nevada WA 3609 Medicaid (Medical Record ...
Terms matched: 1  -  Score: 35  -  12 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PT_34_Therapy_Tip_Sheet.pdf
... paid, or invalid in some other way, federal law requires Medicaid to recover ... paid, or invalid in some other way, federal law requires Medicaid to recover ...
Terms matched: 2  -  Score: 28  -  29 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60.pdf
... paid, or invalid in some other way, federal law requires Medicaid to recover ... paid, or invalid in some other way, federal law requires Medicaid to recover ...
Terms matched: 2  -  Score: 28  -  29 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60_2025-1216.pdf
... of eligibility will not affect the new way of billing for vaccines, as both ... of eligibility will not affect the new way of billing for vaccines, as both ...
Terms matched: 2  -  Score: 54  -  03 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT20-24-77_online_011226_to_040326.pdf
... of eligibility will not affect the new way of billing for vaccines, as both ... of eligibility will not affect the new way of billing for vaccines, as both ...
Terms matched: 2  -  Score: 54  -  03 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT20-24-77.pdf
... to FFS, what is the correct way to request authorization for services to FFS ... to FFS, what is the correct way to request authorization for services to FFS ...
Terms matched: 2  -  Score: 52  -  03 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/ABA_FAQ.pdf
... authorization.... 17 Introduction .... 17 Ways to request authorization .... 18 Expedited ... authorization.... 17 Introduction .... 17 Ways to request authorization .... 18 Expedited ...
Terms matched: 2  -  Score: 108  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
... authorization.... 18 Introduction .... 18 Ways to request authorization .... 19 Expedited ... authorization.... 18 Introduction .... 18 Ways to request authorization .... 19 Expedited ...
Terms matched: 2  -  Score: 108  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20260101.pdf
... @nvha.nv.gov 1. Is there a way to give feedback to Nevada Medicaid or ... @nvha.nv.gov 1. Is there a way to give feedback to Nevada Medicaid or ...
Terms matched: 2  -  Score: 52  -  17 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Nevada%20Medicaid%20FAQS.pdf
... of eligibility will not affect the new way of billing for vaccines, as both ... of eligibility will not affect the new way of billing for vaccines, as both ...
Terms matched: 2  -  Score: 54  -  12 Jan 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT20-24-77_online_101325_to_011226.pdf
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