Nevada Medicaid and Nevada Check Up News (Second 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]

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NOTIFICATION: The following Nevada Medicaid Provider Web Portal services will be unavailable from 4 p.m. Pacific Time on Sunday, October 11, 2026, through 3 a.m. Pacific Time on Monday, October 12, 2026, for scheduled maintenance:
  • All secure Provider Web Portal (PWP) functions
  • Provider Flex
  • Real time CAQH/CORE EDI eligibility and claim verification
  • Provider Pre-Admission Screening Resident Review (PASRR)

IMPORTANT: Nevada Medicaid is conducting a swift revalidation effort on high risk providers. If selected, you will receive a revalidation notice with instructions through the standard communication process. See Web Announcement 3935 for more information.

Known System Issues-Click HERE

Top 10 Claim Denial Reasons and Resolutions/Workarounds for August 2026 Professional Claims. See Web Announcement 4009.

Top Prior Authorization Denial Reasons for the Second Quarter of 2026. See Web Announcement 3978.

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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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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1. NV_EDI_Trading_Partner_User_Guide.pdf
... have different folder options. The “inboundâ€folder is where you will drop files needing to be processed, and the “outboundâ€folder is ...
Terms matched: 1  -  Score: 12  -  15 Sep 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EDI_Trading_Partner_User_Guide.pdf
2. web_announcement_3998_20260903.pdf
... Covered Entities: Reminder: Nevada Medicaid Fee-For-Service (FFS) Will Integrate the 340B Ceiling Price into the 340B Reimbursement Methodology Beginning October 1, 2026 Starting October 1 ...
Terms matched: 1  -  Score: 117  -  03 Sep 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3998_20260903.pdf
3. NV_EVS_User_Manual_Ch3.pdf
... " If the claim is related to accident, select the accident type from the drop- down list • Accident Date â€" Enter the date ...
Terms matched: 1  -  Score: 74  -  19 Aug 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch3.pdf
4. NV_BillingGuidelines_PT33.pdf
... or vehicle modification equipment, such as but not limited to: • Ceiling fans • Elevators • Home security systems • ...
Terms matched: 1  -  Score: 12  -  14 Aug 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT33.pdf
5. NV_BillingGuidelines_PT33_20260730.pdf
... or vehicle modification equipment, such as but not limited to: • Ceiling fans • Elevators • Home security systems • ...
Terms matched: 1  -  Score: 12  -  14 Aug 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT33_20260730.pdf
6. Encounter_NET_837P_Companion_Guide_-_Mod.pdf
... Segment) Appointment Time, Scheduled Pickup Time, Actual Pickup Time, and Actual Drop off Time will be sent in loop 2400, NTE02 data element. Value ...
Terms matched: 1  -  Score: 30  -  04 Aug 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Encounter_NET_837P_Companion_Guide_-_Mod.pdf
7. NV_BillingGuidelines_PT33_20251215.pdf
... or vehicle modification equipment, such as but not limited to: • Ceiling fans • Elevators • Home security systems • ...
Terms matched: 1  -  Score: 12  -  30 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT33_20251215.pdf
8. web_announcement_3971_20260723.pdf
... Medicaid-enrolled 340B Covered Entities: Nevada Medicaid Fee-For-Service (FFS) Will Integrate the 340B Ceiling Price into the 340B Reimbursement Methodology Beginning October 1, 2026 Starting October 1 ...
Terms matched: 1  -  Score: 117  -  23 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3971_20260723.pdf
9. FA-27B.pdf
... brush over a soft towel or the sink that is partially filled with water. Dropping the denture on a hard surface can result in breakage of the pink flange ...
Terms matched: 1  -  Score: 20  -  14 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-27B.pdf
10. web_announcement_3952_20260626.pdf
... The aid code “AOâ€will be an option to choose from the drop -down menu when answering the “Presumptive Eligibility Aid Codeâ€question. ...
Terms matched: 1  -  Score: 21  -  26 Jun 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3952_20260626.pdf
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