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]

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Known System Issues-Click HERE

Top 10 Claim Denial Reasons and Resolutions/Workarounds for October 2025 Professional Claims. See Web Announcement 3767.

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.

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1. Known_Issues.pdf
... , until a resolution is reference not set to an instance of an object in ... copy of their RA. unable to view all of their Remittance Advice (RA ...
Terms matched: 2  -  Score: 55  -  26 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
2. FA-11E.pdf
... or interaction with people in the recipient’s environment or adjustment to the settings in which their functions have diminished. • Target Behavior - Start ...
Terms matched: 1  -  Score: 20  -  26 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-11E.pdf
3. NV_BillingGuidelines_PT43_20250804.pdf
... Billing Guide Laboratory, Pathology Clinical Clinical laboratory tests are furnished primarily in three distinct settings: physician office laboratories, hospital-based laboratories, and independent laboratories. Only independent ...
Terms matched: 1  -  Score: 75  -  18 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT43_20250804.pdf
4. NV_BillingGuidelines_PT43.pdf
... Billing Guide Laboratory, Pathology Clinical Clinical laboratory tests are furnished primarily in three distinct settings: physician office laboratories, hospital-based laboratories, and independent laboratories. Only independent ...
Terms matched: 1  -  Score: 75  -  18 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT43.pdf
5. Provider_Enrollment_Information_Booklet.pdf
... the retroactive time. Please note that this does not extend the timely filing policy set forth in Medicaid Services Manual Chapter 100 Medicaid Program. The list of claims ...
Terms matched: 1  -  Score: 28  -  05 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
6. Error_Code_to_EOB_to_ANSI.pdf
... PLEASE CONTACT THE occurrence has been reached. made for same/similar procedure within set CARE COORDINATOR time frame. 3353 SPECIALIZED FOSTER CARE CHECKLIST 3352 ELIGIBILITY CHECKLIST NOT ...
Terms matched: 1  -  Score: 311  -  04 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
7. NV_BillingGuidelines_PT36.pdf
... contractual terms, limitations, exclusions, coordination of benefits and other terms and conditions set forth by the benefit program. Coverage The chiropractic manual manipulative treatment codes include ...
Terms matched: 1  -  Score: 20  -  28 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT36.pdf
8. NV_BillingGuidelines_PT36_20111001.pdf
... Therapy, (max 30 min): 97110 ï ‚ X-Ray (medically necessary views): 72010-72040 ï ‚ Spinal Manipulation: 98940-98942 The chiropractic manual manipulative treatment ...
Terms matched: 1  -  Score: 20  -  28 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT36_20111001.pdf
9. web_announcement_3753_20251024.pdf
... each plan to help you pick. Use the QR code at the right to view beneï ts. You can continue to use the same providers for up to ...
Terms matched: 1  -  Score: 13  -  24 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3753_20251024.pdf
10. NV_Flex_User_Guide_Individual.pdf
... /17/2025) 5. When applicable, select “Upload/View Filesâ€to upload supervisor credentials/license. 1.6. Contact Information If ...
Terms matched: 1  -  Score: 41  -  21 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Flex_User_Guide_Individual.pdf
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