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 https://NevadaMedicaid.nv.gov/ and the Billing Guide for your provider type at www.medicaid.nv.gov.

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1. Error_Code_to_EOB_to_ANSI.pdf
... (loop 2110 Service Payment Information REF), if present. 3299 HOLIDAY PAY TV MOD BILLED - NOT A 2001 Deny Holiday Pay TV Modifier when not a ...
Terms matched: 1  -  Score: 22  -  09 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
2. Known_Issues.pdf
... with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ...
Terms matched: 1  -  Score: 11  -  17 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
3. NV_EVS_User_Manual_Ch4.pdf
... can be submitted: o Electronically o By mail only if dental x-rays or dental molds that do not allow for electronic submission. Diagnosis Information The first diagnosis entered ...
Terms matched: 1  -  Score: 28  -  15 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch4.pdf
4. 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
5. Encounter-Institutional_837I_MCO_Companion_Guide_-_Mod.pdf
... , FI, HM, LM, MA, MB, MC, OF, TV, VA, WC, ZZ Medicaid MC 2 The value sent at this ...
Terms matched: 1  -  Score: 21  -  06 Feb 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Encounter-Institutional_837I_MCO_Companion_Guide_-_Mod.pdf
6. Encounter-Dental_837D_MCO_Companion_Guide_-_Mod.pdf
... , FI, HM, LM, MA, MB, MC, OF, TV, VA, WC, ZZ Medicaid MC 2 The value sent at this ...
Terms matched: 1  -  Score: 21  -  06 Feb 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Encounter-Dental_837D_MCO_Companion_Guide_-_Mod.pdf
7. Encounter-Professional_837P_MCO_Companion_Guide_-_Mod.pdf
... , FI, HM, LM, MA, MB, MC, OF, TV, VA, WC, ZZ Medicaid MC 2 The value sent at this ...
Terms matched: 1  -  Score: 11  -  06 Feb 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Encounter-Professional_837P_MCO_Companion_Guide_-_Mod.pdf
8. Professional_FFS_837P.pdf
... , FI, HM, LM, MA, MB, MC, OF, TV, VA, WC, ZZ Medicaid MC 2 121 2010BA NM1 Subscriber Name ...
Terms matched: 1  -  Score: 11  -  06 Jan 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Professional_FFS_837P.pdf
9. 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
10. 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
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