Nevada Medicaid and Nevada Check Up News (Fourth 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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EDI Trading Partners: If you have not already scheduled a migration date for your SFTP connection to the new URL, please contact NV MMIS EDI Support immediately. SFTP services at sftp.medicaid.nv.gov will be discontinued starting January 21, 2026.
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Top 10 Claim Denial Reasons and Resolutions/Workarounds for December 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.

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1. 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
2. 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  -  16 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60.pdf
3. Benefit_Enrollment_and_Maintenance_(834).pdf
... Line Codes: Notes / AG, AH, AJ, AK, DCP, ... QTY*TO*2 N1*P5*DIVISION OF HEALTH CARE FINANCING AND ...
Terms matched: 2  -  Score: 21  -  20 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Benefit_Enrollment_and_Maintenance_(834).pdf
4. 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
5. web_announcement_3505_20241217.pdf
... AF Abortion performed due to emotional/psychological health of mother Use of condition codes AH (elective abortion), AC (Abortion performed due to serious fetal genetic ...
Terms matched: 1  -  Score: 20  -  17 Dec 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3505_20241217.pdf
6. Inflammatory_Bowel_Disease_Agents_2017-09.pdf
... , PA. November 2015. ï ‚ Marshall JK, Thabane M, Steinhart AH, et al. Rectal 5-aminosalicylic acid for maintenance of remission in ulcerative colitis ...
Terms matched: 1  -  Score: 24  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Inflammatory_Bowel_Disease_Agents_2017-09.pdf
7. Incretin_Mimetics_Amylinomimetics_2018-06.pdf
... Accessed February 14, 2018. ï ‚ Davies MJ, Donnelly R, Barnett AH, et al. Exenatide compared to long-acting insulin to achieve glycemic control with ...
Terms matched: 1  -  Score: 24  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Incretin_Mimetics_Amylinomimetics_2018-06.pdf
8. Incretin_Mimetics_Amylinomimetics_2017-09.pdf
... Accessed June 14, 2017. ï ‚ Davies MJ, Donnelly R, Barnett AH, et al. Exenatide compared to long-acting insulin to achieve glycemic control with ...
Terms matched: 1  -  Score: 24  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Incretin_Mimetics_Amylinomimetics_2017-09.pdf
9. Incretin_Mimetics_Amylinomimetics_2017-0314.pdf
... Accessed October 31, 2016. ï ‚ Davies MJ, Donnelly R, Barnett AH, et al. Exenatide compared to long-acting insulin to achieve glycemic control with ...
Terms matched: 1  -  Score: 21  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Incretin_Mimetics_Amylinomimetics_2017-0314.pdf
10. Incretin_Mimetics_2014_0811.pdf
... (8 ): 1927-303. 8. Pratley RE, Nauck MA, Barnett AH, Feinglos MN, Ovalle F, Harman-Boehm I, et al. Once ...
Terms matched: 1  -  Score: 49  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Incretin_Mimetics_2014_0811.pdf
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