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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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 dhcfp.nv.gov and the Billing Guide for your provider type at www.medicaid.nv.gov.

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1. 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
2. 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
3. Known_Issues.pdf
... that has been trimmed, bent, molded, assembled, or otherwise customized to ... on the “Request Informationâ€panel that they Application with a letter attached ...
Terms matched: 2  -  Score: 21  -  17 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
4. 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
5. 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
6. 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
7. NV_Billing_General_20251215.pdf
... field. All MCO coverage details can be found in the Managed Care Assignment Details panel. Updated 12/15/2025 Billing Manual Pv10/17/2025 ...
Terms matched: 1  -  Score: 11  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20251215.pdf
8. 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
9. web_announcement_3803_20251229.pdf
... approvals. • A new BCCP Level of Care (LOC) Tier panel has been added to the recipient profile in MMIS. Note: this enhancement ...
Terms matched: 1  -  Score: 44  -  29 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3803_20251229.pdf
10. NV_EVS_User_Manual_Ch4.pdf
... mail only if dental x-rays or dental molds that do not allow for electronic submission ... is first displayed, all of the panels are expanded. Collapse: Click on ...
Terms matched: 2  -  Score: 118  -  15 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch4.pdf
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