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. Error_Code_to_EOB_to_ANSI.pdf
... ) . Usage: Do not use designation code. this code for claims attachment ... . for same/similar procedure within set time COORDINATOR frame. 3353 SPECIALIZED FOSTER ...
Terms matched: 2  -  Score: 355  -  09 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
2. NV_BillingGuidelines_PT17_Spec181.pdf
... by an FQHC, regardless of whether the FQHC is the recipient’s designated primary care provider. • MEDICAL services under Managed Care invoice using ...
Terms matched: 1  -  Score: 20  -  06 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT17_Spec181.pdf
3. ABA_FAQ.pdf
... home and office settings? You can designate the training location by using the appropriate ... place in both the home and office settings? You can designate the training location ...
Terms matched: 2  -  Score: 41  -  03 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/ABA_FAQ.pdf
4. NV_BillingGuidelines_PT25-41_20241218.pdf
... contractual terms, limitations, exclusions, coordination of benefits and other terms and conditions set forth by the benefit program. Updated 12/18/2024 Provider Type ...
Terms matched: 1  -  Score: 20  -  03 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT25-41_20241218.pdf
5. NV_BillingGuidelines_PT25-41.pdf
... contractual terms, limitations, exclusions, coordination of benefits and other terms and conditions set forth by the benefit program. Updated 03/03/2026 Provider Type ...
Terms matched: 1  -  Score: 20  -  03 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT25-41.pdf
6. Provider_Enrollment_Information_Booklet.pdf
... codes: • 031: Designated Mobile Crisis Team (DMCT) 87 ... does not extend the timely filing policy set forth in Medicaid Services Manual Chapter 100 ...
Terms matched: 2  -  Score: 58  -  27 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
7. FA-1D.pdf
... contractual terms, limitations, exclusions, coordination of benefits and other terms and conditions set forth by the benefit program. The information on this form and on accompanying ...
Terms matched: 1  -  Score: 20  -  23 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-1D.pdf
8. NV_Billing_General.pdf
... 38, 40-41, 33 and ICN designations; updated requirements for the Claim Appeal ... for: • Following regulations set forth in the Medicaid Services Manual ( ...
Terms matched: 2  -  Score: 129  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
9. NV_Billing_General_20260101.pdf
... 38, 40-41, 33 and ICN designations; updated requirements for the Claim Appeal ... for: • Following regulations set forth in the Medicaid Services Manual ( ...
Terms matched: 2  -  Score: 129  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20260101.pdf
10. NV_Flex_User_Guide_Getting_Started.pdf
... Multi-Factor Authentication Reset (MFA) .... 32 Use Existing Provider Web Portal MFA Setting for Flex .... 38 1.8. Dashboard Overview.... 41 Provider Enrollment Booklet... ...
Terms matched: 1  -  Score: 80  -  18 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Flex_User_Guide_Getting_Started.pdf
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