Nevada Medicaid and Nevada Check Up News (Third 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]

Notifications

Provider Flex is now LIVE for all provider types!
For information and training opportunities on this exciting new enrollment tool, please visit our Provider Flex page

Multi-Factor Authentication Frequently Asked Questions

Known System Issues-Click HERE

Top 10 Claim Denial Reasons and Resolutions/Workarounds for November 2025 Professional Claims. See Web Announcement 3789.

Top Prior Authorization Denial Reasons for the Third Quarter of 2025. See Web Announcement 3758.

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.

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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... General Information.... 1 Nevada Medicaid Provider Types and Specialties.... 1 Table 1: ... Health Transport Chiropractor Specialty type codes: 36 • 836: Chiropractor Group ...
Terms matched: 2  -  Score: 518  -  23 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
... Provider Enrollment Checklist Provider Type 93: Substance Use Treatment Specialty 704: Residential Substance Use Treatment in an Institution for Mental Disease (IMD) Please refer to ...
Terms matched: 1  -  Score: 75  -  23 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EnrollmentChecklist_PT93_Spec704_Flex.pdf
... Provider Enrollment Checklist Provider Type 93: Substance Use Treatment Specialty 707: Substance Use Treatment Clinic Please refer to the Provider Enrollment Information Booklet for guidance and to ...
Terms matched: 1  -  Score: 74  -  23 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EnrollmentChecklist_PT93_Spec707_Flex.pdf
... 188 Claims, Claims submitted by provider types 24-(Advanced • ... PCS) on the Web Portal. 36 Claims, PCS Some claims may be ...
Terms matched: 2  -  Score: 379  -  23 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
... Provider Type 85 Billing Guide Applied Behavior Analysis (ABA) State Policy The Medicaid Services Manual (MSM) is on the Nevada Medicaid website at http: ...
Terms matched: 1  -  Score: 232  -  22 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT85.pdf
... Provider Type 85 Billing Guide Applied Behavior Analysis (ABA) State Policy The Medicaid Services Manual (MSM) is on the Division of Health Care Financing and ...
Terms matched: 1  -  Score: 232  -  22 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT85_20250304.pdf
... Provider Type 60 Billing Guide School Health Services (SHS) Table of Contents ... Guide pv 08/10/2023 36 / 78 Provider Type 60 Billing Guide ...
Terms matched: 2  -  Score: 531  -  16 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60_2024-0828.pdf
... Provider Type 60 Billing Guide School Health Services (SHS) Table of Contents ... Guide pv 08/28/2024 36 / 78 Provider Type 60 Billing Guide ...
Terms matched: 2  -  Score: 531  -  16 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60.pdf
... on the same date of service. 1 service unit (complete series) per 36 rolling months. D0220 Intraoral - Periapical first radiographic image 1 service unit per ...
Terms matched: 1  -  Score: 263  -  16 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentB.pdf
... on the same date of service. 1 service unit (complete series) per 36 rolling months. D0220 Intraoral - Periapical first radiographic image 1 service unit per ...
Terms matched: 1  -  Score: 263  -  15 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentB_12-08-25.pdf
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