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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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. FA-11.pdf
... contractual terms, limitations, exclusions, coordination of benefits and other terms and conditions set forth by the benefit program. The information contained in this form, including ...
Terms matched: 1  -  Score: 26  -  09 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-11.pdf
2. Known_Issues.pdf
... without using the copy System.NullReferenceException: Object functionality, until a resolution is reference not set to an instance of an object in place. 10 Web Portal, The ...
Terms matched: 1  -  Score: 14  -  08 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
3. Error_Code_to_EOB_to_ANSI.pdf
... PLEASE CONTACT THE occurrence has been reached. made for same/similar procedure within set CARE COORDINATOR time frame. Updated: 04/08/2026 Page 134 ...
Terms matched: 1  -  Score: 312  -  08 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
4. NV_BillingGuidelines_PT20-24-77.pdf
... for Nursing Mothers with infants up to 12 months of age . In the outpatient setting, PT 20 (Physician), PT 24 (APRN), and ...
Terms matched: 1  -  Score: 24  -  03 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT20-24-77.pdf
5. NV_BillingGuidelines_PT20-24-77_online_011226_to_040326.pdf
... for Nursing Mothers with infants up to 12 months of age . In the outpatient setting, PT 20 (Physician), PT 24 (APRN), and ...
Terms matched: 1  -  Score: 24  -  03 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT20-24-77_online_011226_to_040326.pdf
6. web_announcement_2858_20220729.pdf
... licensed providers may appropriately enroll as Nevada Medicaid providers, in accordance with licensure requirements set forth in Senate Bill (SB) 44. The Licensed Master Social Worker ...
Terms matched: 1  -  Score: 23  -  01 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2858_20220729.pdf
7. Provider_Enrollment_Information_Booklet.pdf
... the retroactive time. Please note that this does not extend the timely filing policy set forth in Medicaid Services Manual Chapter 100 Medicaid Program. The list of claims ...
Terms matched: 1  -  Score: 28  -  25 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
8. NV_BillingGuidelines_PT43_20251118.pdf
... Billing Guide Laboratory, Pathology Clinical Clinical laboratory tests are furnished primarily in three distinct settings: physician office laboratories, hospital-based laboratories, and independent laboratories. Only independent ...
Terms matched: 1  -  Score: 75  -  25 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT43_20251118.pdf
9. NV_BillingGuidelines_PT43.pdf
... Billing Guide Laboratory, Pathology Clinical Clinical laboratory tests are furnished primarily in three distinct settings: physician office laboratories, hospital-based laboratories, and independent laboratories. Only independent ...
Terms matched: 1  -  Score: 75  -  25 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT43.pdf
10. FA-13A.pdf
... to facilitate a recipient’s discharge back to their home or less restrictive setting based on individualized treatment planning needs and upon the recommendations of the clinical treatment ...
Terms matched: 1  -  Score: 23  -  20 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-13A.pdf
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