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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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 September 2026 Professional Claims. See Web Announcement 4031.

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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1. NCPDP_Encounter_Companion_Guide.pdf
... DF Drug-Food interaction â€" Indicates interactions between a drug and certain foods. DI Drug Incompatibility â€" Indicates physical and chemical incompatibilities between two or more ...
Terms matched: 1  -  Score: 11  -  15 Sep 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NCPDP_Encounter_Companion_Guide.pdf
2. NV_BillingGuidelines_PT30-83_online_013119.pdf
... ) • Chore services (heavy household chores such as cleaning windows and walls, shampooing carpets, moving heavy furniture, minor home repairs and yard work ...
Terms matched: 1  -  Score: 23  -  11 Aug 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT30-83_online_013119.pdf
3. 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
4. NV_BillingGuidelines_PT34.pdf
... an aerosol generator, nebulizer, metered dose inhaler or IPPB device 94667 Manipulation chest wall, such as cupping, percussing, Required and vibration to facilitate lung function ...
Terms matched: 1  -  Score: 24  -  28 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT34.pdf
5. FA-16B.pdf
... PT = Physical Therapy ï Oxygen via trach continuously HFCWO Vest = High Frequency Chest Wall Oscillation Vest ï Oxygen via vent continuously ï No Chest PT, HFCWO Vest ...
Terms matched: 1  -  Score: 12  -  14 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-16B.pdf
6. NV_BillingGuidelines_PT34_2026-0101.pdf
... an aerosol generator, nebulizer, metered dose inhaler or IPPB device 94667 Manipulation chest wall, such as cupping, percussing, Required and vibration to facilitate lung function ...
Terms matched: 1  -  Score: 24  -  02 Jun 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT34_2026-0101.pdf
7. PT_34_Therapy_Tip_Sheet.pdf
... Authorization Nevada Medicaid Criteria YouTube: PA Search Overview Provider Day Calculator Web Portal Fee WA 1728 Schedule (FA-7 Search Information) Nevada WA 3609 Medicaid (Medical Record ...
Terms matched: 1  -  Score: 35  -  12 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PT_34_Therapy_Tip_Sheet.pdf
8. NV_BillingGuidelines_PT34_2023-1121.pdf
... an aerosol generator, nebulizer, metered dose inhaler or IPPB device 94667 Manipulation chest wall, such as cupping, percussing, Required and vibration to facilitate lung function ...
Terms matched: 1  -  Score: 24  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT34_2023-1121.pdf
9. web_announcement_Volume 22 Issue 3_20250930.pdf
... QRR) surveys may assist in justifying rate adjustments. Data gathered from provider responses di- rectly contributes to the analysis of current reimbursement rates and may assist in ...
Terms matched: 1  -  Score: 13  -  30 Sep 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_Volume%2022%20Issue%203_20250930.pdf
10. 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
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