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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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 dhcfp.nv.gov and the Billing Guide for your provider type at www.medicaid.nv.gov.

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1. NV_Billing_General_20260101.pdf
... Partner User Guide The Trading Partner User Guide provides instruction for establishing a Trading Partner Profile (TPP), selecting the appropriate connectivity method and the testing process. ...
Terms matched: 1  -  Score: 29  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20260101.pdf
2. NV_Billing_General.pdf
... Partner User Guide The Trading Partner User Guide provides instruction for establishing a Trading Partner Profile (TPP), selecting the appropriate connectivity method and the testing process. ...
Terms matched: 1  -  Score: 29  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
3. NV_EVS_User_Manual_Ch1.pdf
... provider .... 13 1.5. Provider information .... 15 1.6. Updating provider profile .... 18 1.7. Granting access to a delegate.... 21 1.7.1. ...
Terms matched: 1  -  Score: 157  -  18 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch1.pdf
4. NV_Flex_User_Guide_Getting_Started.pdf
... is found, the User ID is sent to the email address associated with the profile. Updated 02/18/2026 Page 15 of 45 pv09/02 ...
Terms matched: 1  -  Score: 25  -  18 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Flex_User_Guide_Getting_Started.pdf
5. web_announcement_3820_20260120.pdf
... Care (LOC), and Nursing Facility Tracking (NFT) Requests Under One Profile Effective March 16, 2026, Nevada Medicaid and Nevada Check Up providers will ...
Terms matched: 1  -  Score: 37  -  06 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3820_20260120.pdf
6. NV_BillingGuidelines_PT20-24-77_online_101325_to_011226.pdf
... incompetent cervix, or maternal history of premature delivery < 35 weeks 76818 Fetal biophysical profile Third • High risk for significant fetal academia with non-stress testing trimester ...
Terms matched: 1  -  Score: 12  -  12 Jan 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT20-24-77_online_101325_to_011226.pdf
7. NV_BillingGuidelines_PT20-24-77.pdf
... incompetent cervix, or maternal history of premature delivery < 35 weeks 76818 Fetal biophysical profile Third • High risk for significant fetal academia with non-stress testing trimester ...
Terms matched: 1  -  Score: 12  -  12 Jan 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT20-24-77.pdf
8. NV_Billing_General_20251017.pdf
... Partner User Guide The Trading Partner User Guide provides instruction for establishing a Trading Partner Profile (TPP), selecting the appropriate connectivity method and the testing process. ...
Terms matched: 1  -  Score: 29  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20251017.pdf
9. NV_Billing_General_20251215.pdf
... Partner User Guide The Trading Partner User Guide provides instruction for establishing a Trading Partner Profile (TPP), selecting the appropriate connectivity method and the testing process. ...
Terms matched: 1  -  Score: 29  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20251215.pdf
10. NV_BillingGuidelines_PT74.pdf
... cervix, or maternal history of premature delivery < 35 weeks 76818, Fetal biophysical profile Third • High risk for significant fetal academia 76819 with non-stress testing ...
Terms matched: 1  -  Score: 13  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT74.pdf
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