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 4053.

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. web_announcement_4023_20261001.pdf
... Residential Treatment Facilities): Age Correction for Complex Case Criteria Correction to Web Announcement 3970: The special rate for private psychiatric residential treatment facilities (PRTF) for ...
Terms matched: 1  -  Score: 38  -  01 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_4023_20261001.pdf
2. web_announcement_3970_20260722.pdf
... July 22, 2026 (Updated October 1, 2026) Nevada Medicaid Web Announcement 3970 Attention Provider Type 63 (Psychiatric Residential Treatment Facility (PRTF)): ...
Terms matched: 1  -  Score: 38  -  01 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3970_20260722.pdf
3. NV_BillingGuidelines_PT60.pdf
... other qualified health care professional on the same day of the procedure or other service AH Licensed Board of Examiners Psychologist AM Physician, team member service CO Outpatient Occupational ...
Terms matched: 1  -  Score: 14  -  28 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60.pdf
4. web_announcement_3972_20260723.pdf
... , 2025. For additional information on this rate increase, please see Web Announcement 3970. Nevada Medicaid is making a one-time exception to reimburse providers at the reimbursement ...
Terms matched: 1  -  Score: 21  -  23 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3972_20260723.pdf
5. Benefit_Enrollment_and_Maintenance_(834).pdf
... 2300 HD03 Insurance Line Code See the Insurance Line Codes: Notes / AG, AH, AJ, AK, DCP, Comments DEN, EPO, FAC, ...
Terms matched: 1  -  Score: 11  -  06 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Benefit_Enrollment_and_Maintenance_(834).pdf
6. NV_BillingGuidelines_PT60_2026-0429.pdf
... other qualified health care professional on the same day of the procedure or other service AH Licensed Board of Examiners Psychologist AM Physician, team member service CO Outpatient Occupational ...
Terms matched: 1  -  Score: 14  -  19 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60_2026-0429.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_PT60_2025-1216.pdf
... other qualified health care professional on the same day of the procedure or other service AH Licensed Board of Examiners Psychologist AM Physician, team member service CO Outpatient Occupational ...
Terms matched: 1  -  Score: 14  -  29 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60_2025-1216.pdf
9. NV_BillingGuidelines_PT60_2024-0828.pdf
... other qualified health care professional on the same day of the procedure or other service AH Licensed Board of Examiners Psychologist AM Physician, team member service CO Outpatient Occupational ...
Terms matched: 1  -  Score: 14  -  16 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60_2024-0828.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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