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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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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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

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1. Team_Territories.pdf
... ¢ 21 â€" Podiatrist • 32 â€" Ambulance, Air or Ground • 34 â€" Therapy • 35 ...
Terms matched: 1  -  Score: 21  -  08 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Team_Territories.pdf
2. Provider_Enrollment_Information_Booklet.pdf
... ¢ 930: Personal Care Services - Provider Agency (EVV Required) Ambulance, Air or Ground Specialty type code: 32 • 249: Community Paramedicine ...
Terms matched: 1  -  Score: 34  -  21 Sep 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
3. Known_Issues.pdf
... billable by PT 32 ambulance • Claims will be automatically (Ambulance, Air providers for procedure codes (other than reprocessed. or Ground) procedure code ...
Terms matched: 1  -  Score: 49  -  01 Sep 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
4. NV_BillingGuidelines_PT33.pdf
... corner chairs Household items, such as but not limited to: • Air conditioners (includes swamp coolers) • Appliances (microwave, cutting ...
Terms matched: 1  -  Score: 24  -  14 Aug 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT33.pdf
5. NV_BillingGuidelines_PT33_20260730.pdf
... corner chairs Household items, such as but not limited to: • Air conditioners (includes swamp coolers) • Appliances (microwave, cutting ...
Terms matched: 1  -  Score: 24  -  14 Aug 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT33_20260730.pdf
6. NV_BillingGuidelines_PT23-76.pdf
... limited to PA is always required. non-repairable out of warranty cases) L8621 Zinc air battery for use with cochlear implant device, Hearing aid batteries are limited to ...
Terms matched: 1  -  Score: 20  -  04 Aug 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT23-76.pdf
7. NV_Billing_Justice_Initiative.pdf
... ) Audiology (Hearing) Code Descriptions Limitations 92551 Screening test, pure tone, air only 92552 Pure tone audiometry; air only 92553 Pure tone audiometry; air ...
Terms matched: 1  -  Score: 35  -  03 Aug 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_Justice_Initiative.pdf
8. NV_Billing_EMO.pdf
... Prescribed Drugs for additional information. Transportation Services Limited to emergency transport (ground or air) to a hospital emergency department (ED) and non-emergency medical transportation to ...
Terms matched: 1  -  Score: 21  -  03 Aug 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_EMO.pdf
9. NV_Flex_User_Guide_Getting_Started.pdf
... ii@ino Szztacll Frqu@nay Guasiona Asa@d iR&GAW 2rosier rab Pert&s @sic2 Referencmade ir@ming vi@cotcnYoviiubz (UzinG ...
Terms matched: 1  -  Score: 12  -  31 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Flex_User_Guide_Getting_Started.pdf
10. NV_Flex_User_Guide_Individual.pdf
... œEFT Enrollmentâ€section will not display for individual provider types 32 (Ambulance, Air or Ground) and 89 (Community Health Worker) or for individuals with ...
Terms matched: 1  -  Score: 12  -  31 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Flex_User_Guide_Individual.pdf
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