Nevada Medicaid and Nevada Check Up News (First 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 8 p.m. Pacific Time on Monday, May 11, 2026, through 4 a.m. Pacific Time on Tuesday, May 12, 2026, for scheduled maintenance:
  • All secure Provider Web Portal (PWP) functions
  • Provider Flex
  • Gabby®, which includes:
    • Gainwell Technologies Contact Center (877) 638-3472
    • Automated Response System (ARS) (800) 942-6511
  • Real time CAQH/CORE EDI eligibility and claim verification
  • Provider Pre-Admission Screening Resident Review (PASRR)
    • Known System Issues-Click HERE

    Top 10 Claim Denial Reasons and Resolutions/Workarounds for March 2026 Professional Claims. See Web Announcement 3894.

    Top Prior Authorization Denial Reasons for the First Quarter of 2026. See Web Announcement 3900.

    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. Known_Issues.pdf
... 24 Units Alwd/Day) automatically re-processed. • 5537-(One Unit Allowed Per Day) • 5538-(Thirty-Two Units Allowed ...
Terms matched: 1  -  Score: 130  -  06 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
2. Error_Code_to_EOB_to_ANSI.pdf
... , if present. 3299 HOLIDAY PAY TV MOD BILLED - NOT A 2001 Deny ... )/ other documentation. At least one Remark Code must be provided (may ...
Terms matched: 2  -  Score: 367  -  06 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
3. NV_BillingGuidelines_PT11.pdf
... you are requesting and specify the days for each when you are requesting more than one level of care. • Include only the medical records that support ...
Terms matched: 1  -  Score: 112  -  01 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT11.pdf
4. NV_BillingGuidelines_PT11_online_082725.pdf
... you are requesting and specify the days for each when you are requesting more than one level of care. • Include only the medical records that support ...
Terms matched: 1  -  Score: 112  -  01 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT11_online_082725.pdf
5. NV_BillingGuidelines_PT60_2025-1216.pdf
... , each 15 minutes or each 30 minutes, each of these timed segments equals one unit. Enter the number of units on the claim; do not enter ...
Terms matched: 1  -  Score: 416  -  29 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60_2025-1216.pdf
6. NV_BillingGuidelines_PT60.pdf
... , each 15 minutes or each 30 minutes, each of these timed segments equals one unit. Enter the number of units on the claim; do not enter ...
Terms matched: 1  -  Score: 416  -  29 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60.pdf
7. web_announcement_3891_20260410.pdf
... between April 1, 2026, and April 10, 2026, and denied with one of the following error codes will be reprocessed automatically: • 3802 ...
Terms matched: 1  -  Score: 21  -  27 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3891_20260410.pdf
8. web_announcement_3897_20260421.pdf
... each month. All providers, delegates and/or staff are invited to attend one or more of the training sessions listed below that are being held in May ...
Terms matched: 1  -  Score: 23  -  22 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3897_20260421.pdf
9. Provider_Enrollment_Information_Booklet.pdf
... has their current email and mailing addresses on file. Providers may revalidate up to one year in advance of their revalidation due date. Login to the Provider Web ...
Terms matched: 1  -  Score: 136  -  21 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
10. FA-30.pdf
... Notes Reason for seeking out-of-state placement (this section must be complete; more than one box can be checked) Exit Seeking/Flight Risk Behavior Wandering Behavior Violent ...
Terms matched: 1  -  Score: 23  -  16 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-30.pdf
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