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. Error_Code_to_EOB_to_ANSI.pdf
... not use this provider/supplier primary identifier. code ... present. 3299 HOLIDAY PAY TV MOD BILLED - NOT ... HOLIDAY - 2001 Deny Holiday Pay TV Modifier when not ...
Terms matched: 3  -  Score: 206  -  12 Nov 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
2. PASRR_LOC_NF_Training_2021.pdf
... Alert for Existing Applicant Nevada Medicaid â€" PASRR / LOC / NF Training 32 Error Alert for Existing Applicant Error Alert for Existing Applicant The error alert for ...
Terms matched: 1  -  Score: 14  -  27 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PASRR_LOC_NF_Training_2021.pdf
3. NV_Billing_General.pdf
... and Disposable Medical Supplies (DMEPOS) suppliers who must revalidate every three (3 ... enroll as a Trading Partner .... 32 Chapter 7: Frequently asked billing questions... ...
Terms matched: 2  -  Score: 48  -  22 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
4. NV_Billing_General_20261008.pdf
... and Disposable Medical Supplies (DMEPOS) suppliers who must revalidate every three (3 ... 6: Electronic data interchange .... 32 EDI defined.... 32 Common EDI terms ...
Terms matched: 2  -  Score: 76  -  22 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20261008.pdf
5. NV_BillingGuidelines_PT32_Spec_249_online_20260727.pdf
... Provider Type 32 Specialty 249 Billing Guide Community Paramedicine Policy Starting with dates of service on or after July 1, 2016, Community Paramedicine is a billable service ...
Terms matched: 1  -  Score: 220  -  21 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT32_Spec_249_online_20260727.pdf
6. NV_BillingGuidelines_PT32_Spec_249.pdf
... Provider Type 32 Specialty 249 Billing Guide Community Paramedicine Policy Community Paramedicine is a billable service under Provider Type (PT) 32 specialty 249. Services must be ...
Terms matched: 1  -  Score: 198  -  21 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT32_Spec_249.pdf
7. NV_EVS_User_Manual_Ch4.pdf
... recipient will remain in focus even if the user checks details on another recipient. 32 6. Click the authorization listed under the Your Member Authorizations heading. You ...
Terms matched: 1  -  Score: 12  -  20 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch4.pdf
8. Provider_Enrollment_Information_Booklet.pdf
... , Equipment and Gases (MDEG) Supplier OR o as a Pharmacy (Exception ... Air or Ground Specialty type code: 32 • 249: Community Paramedicine ...
Terms matched: 2  -  Score: 81  -  19 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
9. NV_Billing_General_20260710.pdf
... and Disposable Medical Supplies (DMEPOS) suppliers who must revalidate every three (3 ... 6: Electronic data interchange .... 32 EDI defined.... 32 Common EDI terms... ...
Terms matched: 2  -  Score: 76  -  08 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20260710.pdf
10. Team_Territories.pdf
... (CCBHC)) • 21 â€" Podiatrist • 32 â€" Ambulance, Air or Ground • 34 †...
Terms matched: 1  -  Score: 21  -  08 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Team_Territories.pdf
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