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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Notifications

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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Scheduled Site Maintenance

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_Billing_General_20260710.pdf
... field. All MCO coverage details can be found in the Managed Care Assignment Details panel. The PWP User Manual provides additional details on the PWP eligibility request and ...
Terms matched: 1  -  Score: 11  -  08 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20260710.pdf
2. NV_Billing_General.pdf
... field. All MCO coverage details can be found in the Managed Care Assignment Details panel. The PWP User Manual provides additional details on the PWP eligibility request and ...
Terms matched: 1  -  Score: 11  -  08 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
3. web_announcement_4024_20261002.pdf
... Care Services Codes The American Medical Association (AMA)â €™ s Editorial Panel has released updated maternity care service coding guidelines, with recommended adoption beginning January ...
Terms matched: 1  -  Score: 23  -  02 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_4024_20261002.pdf
4. NV_EDI_Trading_Partner_User_Guide.pdf
... one of the sections, users will click the section title in the left navigation panel to go to that section and make any desired edits. B. To ...
Terms matched: 1  -  Score: 28  -  15 Sep 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EDI_Trading_Partner_User_Guide.pdf
5. Known_Issues.pdf
... on the “Request Informationâ€panel that Application with a letter attached Applications ... that has been trimmed, bent, molded, assembled, or otherwise customized to ...
Terms matched: 2  -  Score: 21  -  01 Sep 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
6. NV_EVS_User_Manual_Ch3.pdf
... primary, check this box; When this box is checked the Other Insurance Information panel will appear on the Submit Dental Claim: Step 2 • Total ...
Terms matched: 1  -  Score: 316  -  19 Aug 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch3.pdf
7. NV_EVS_User_Manual_Ch4.pdf
... is first displayed, all of the panels are expanded. Collapse: Click on ... mail only if dental x-rays or dental molds that do not allow for electronic submission ...
Terms matched: 2  -  Score: 101  -  19 Aug 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch4.pdf
8. NV_EVS_User_Manual_Ch7.pdf
... 2. Enter www.medicaid.nv.gov in the address bar. 3. From the Featured Links panel on the left-hand side of the home page, click Search Providers. To ...
Terms matched: 1  -  Score: 21  -  19 Aug 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch7.pdf
9. NV_EVS_User_Manual_Ch8.pdf
... attachments using the PWP: • Upload the attachment using the File Exchange panel in the PWP. It is recommended that the attachment should be uploaded prior ...
Terms matched: 1  -  Score: 20  -  19 Aug 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch8.pdf
10. Pregnancy_Presumptive_Eligibility_Instructions.pdf
... Medicaid 2/4 Participation Guidelines and Billing Instructions Pregnancy Presumptive Eligibility Labs 80055 Obstetric panel 84702 - 84703 Gonadotropin 80081 Obstetric panel (incl. HIV testing) 85013 ...
Terms matched: 1  -  Score: 37  -  03 Aug 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Pregnancy_Presumptive_Eligibility_Instructions.pdf
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