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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NOTIFICATION: The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. to midnight Pacific Time on Sunday, March 22, 2026, for scheduled maintenance:
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Top 10 Claim Denial Reasons and Resolutions/Workarounds for February 2026 Professional Claims. See Web Announcement 3863.

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

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. 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. Immunomodulators_2015-0930.pdf
... vaccines should not be given concurrently with canakinumab or rilonacept. Macrophage activation syndrome (MAS) is a known, life-threatening disorder that may develop in patients with rheumatic ...
Terms matched: 1  -  Score: 45  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Immunomodulators_2015-0930.pdf
3. Immunomodulators_2015-0812.pdf
... vaccines should not be given concurrently with canakinumab or rilonacept. Macrophage activation syndrome (MAS) is a known, life-threatening disorder that may develop in patients with rheumatic ...
Terms matched: 1  -  Score: 45  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Immunomodulators_2015-0812.pdf
4. Immunomodulators_2014-0918.pdf
... leflunomide. Initial treatment of systemic JIA with features concerning for macrophage activation syndrome (MAS) • Use of anakinra is recommended as one treatment option for ...
Terms matched: 1  -  Score: 37  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Immunomodulators_2014-0918.pdf
5. Immunomodulators 2014 11.pdf
... leflunomide. Initial treatment of systemic JIA with features concerning for macrophage activation syndrome (MAS) • Use of anakinra is recommended as one treatment option for ...
Terms matched: 1  -  Score: 37  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Immunomodulators%202014%2011.pdf
6. 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
7. 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
8. E-Binder_PT_September_2018.pdf
... , Raichlen JS, Riley WA, et al. ... ï ‚ Hamrah P, Dana R. Allergic conjunctivitis ... Management. UpToDate Web site. www.uptodate.com. Updated December ...
Terms matched: 3  -  Score: 41  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_PT_September_2018.pdf
9. E-Binder_PT_September_2017.pdf
... JR 3rd, Raichlen JS, Riley WA, et al. Effect of rosuvastatin ... ), and meta- analyses (MAs) are included in this review. ...
Terms matched: 2  -  Score: 122  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_PT_September_2017.pdf
10. E-Binder_September_2015.pdf
... 2008; 103(3 ): 462-468. 28. Farré M, Mas A, Torrens M, Moreno V, Cami J. Retention rate and ...
Terms matched: 1  -  Score: 11  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_September_2015.pdf
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