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. PASRR_LOC_NF_Training_2021.pdf
... " PASRR / LOC / NF Training 40 PASRR Page 2, continued PASRR Page ... " PASRR / LOC / NF Training 40 PASRR Page 2, continued PASRR Page ...
Terms matched: 2  -  Score: 25  -  27 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PASRR_LOC_NF_Training_2021.pdf
2. NV_Billing_General.pdf
... .... 39 Provider payment .... 40 Glossary .... 41 Updated 10/ ... .... 39 Provider payment .... 40 Glossary .... 41 Updated 10/ ...
Terms matched: 2  -  Score: 87  -  22 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
3. NV_Billing_General_20261008.pdf
... .... 39 Suspended claims .... 40 Denied claims.... 40 Resubmitting a denied ... .... 39 Suspended claims .... 40 Denied claims.... 40 Resubmitting a denied ...
Terms matched: 2  -  Score: 124  -  22 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20261008.pdf
4. NV_EVS_User_Manual_Ch4.pdf
... 39 4.12. Authorization Criteria .... 40 Additional Resources .... 47 PWP User ... 39 4.12. Authorization Criteria .... 40 Additional Resources .... 47 PWP User ...
Terms matched: 2  -  Score: 62  -  20 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch4.pdf
5. Provider_Enrollment_Information_Booklet.pdf
... CRNA) license Provider Enrollment Information Booklet 40 10/19/2026 Provider Specialty ... CRNA) license Provider Enrollment Information Booklet 40 10/19/2026 Provider Specialty ...
Terms matched: 2  -  Score: 21  -  19 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
6. NV_BillingGuidelines_PT85.pdf
... Unit Session Limit Prior Authorization Limit of 40 hours per recipient per week combined, ... Unit Session Limit Prior Authorization Limit of 40 hours per recipient per week combined, ...
Terms matched: 2  -  Score: 24  -  13 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT85.pdf
7. NV_BillingGuidelines_PT85_20260727.pdf
... CPT Professional Edition code book Limit of 40 hours per recipient per week combined, ... CPT Professional Edition code book Limit of 40 hours per recipient per week combined, ...
Terms matched: 2  -  Score: 24  -  13 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT85_20260727.pdf
8. NV_Billing_General_20260710.pdf
... ICN.... 39 Suspended claims .... 40 Denied claims.... 40 Resubmitting a denied ... ICN.... 39 Suspended claims .... 40 Denied claims.... 40 Resubmitting a denied ...
Terms matched: 2  -  Score: 124  -  08 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20260710.pdf
9. Error_Code_to_EOB_to_ANSI.pdf
... : 10/06/2026 Page 40 of 162 Claim Error/EOB/ ... : 10/06/2026 Page 40 of 162 Claim Error/EOB/ ...
Terms matched: 2  -  Score: 208  -  06 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
10. 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
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