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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NOTIFICATION: The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. to midnight Pacific Time on Sunday, March 22, 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 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. NV_EVS_User_Manual_Ch1.pdf
... Healthcare but has the ability to switch to an available provider, Dr. David Green. By checking on David Green, the delegate will no longer be logged ...
Terms matched: 1  -  Score: 24  -  18 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch1.pdf
2. web_announcement_3711_20250904.pdf
... ://www.pahrumplibrary.org/ Henderson District Public Library Pershing County Library 280 S. Green Valley Parkway 1125 Central Avenue Henderson, NV 89012 Lovelock, NV 89419-0781 https ...
Terms matched: 1  -  Score: 20  -  04 Sep 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3711_20250904.pdf
3. FA-1B.pdf
... place of residency Hospital Nursing Facility ICF / MR Group Home Assisted Living Private Home Apartment Temporary Lodging Other (specify): ____ Length of Residency: ____ ...
Terms matched: 1  -  Score: 16  -  09 May 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-1B.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. Inhaled Antimuscarinics.pdf
... nebulization: maintenance, 500 Î ¼ g QID, dose six to eight hours apart Tiotropium Maintenance treatment of bronchospasm Safety and Powder for oral associated with chronic obstructive ...
Terms matched: 1  -  Score: 11  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Inhaled%20Antimuscarinics.pdf
6. Inhaled Antimuscarinics 2012 12.pdf
... , 500 nebulization ® Î ¼ g QID, dose six to eight hours apart (Atrovent ): 500 Î ¼ g (0.02%) Tiotropium Maintenance ...
Terms matched: 1  -  Score: 11  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Inhaled%20Antimuscarinics%202012%2012.pdf
7. Inhaled Anticholinergics.pdf
... %) 500 Î ¼ g four times daily, dose six to eight hours apart Tiotropium Asthma, maintenance treatment: Asthma (12 years Aerosol for Aerosol for ...
Terms matched: 1  -  Score: 11  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Inhaled%20Anticholinergics.pdf
8. Incretin_Mimetics_Amylinomimetics_2018-06.pdf
... or before the 2 main meals of the day, approximately 6 hours or more apart) . Ozempic Injection SC Once weekly Inject in the thigh, abdomen, ...
Terms matched: 1  -  Score: 12  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Incretin_Mimetics_Amylinomimetics_2018-06.pdf
9. Incretin_Mimetics_Amylinomimetics_2017-09.pdf
... or before the 2 main meals of the day, approximately 6 hours or more apart) . Symlin Injection SC Prior to major Inject in the thigh or abdomen ...
Terms matched: 1  -  Score: 12  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Incretin_Mimetics_Amylinomimetics_2017-09.pdf
10. Incretin_Mimetics_Amylinomimetics_2017-0314.pdf
... Considerations before the 2 main meals of the day, approximately 6 hours or more apart) . BYDUREON Injection tray: Administer 2 mg SC If a dose is ...
Terms matched: 1  -  Score: 11  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Incretin_Mimetics_Amylinomimetics_2017-0314.pdf
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