Nevada Medicaid and Nevada Check Up News (First 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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NOTIFICATION: The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. Pacific Time on Monday, May 11, 2026, through 4 a.m. Pacific Time on Tuesday, May 12, 2026, for scheduled maintenance:
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    • Known System Issues-Click HERE

    Top 10 Claim Denial Reasons and Resolutions/Workarounds for March 2026 Professional Claims. See Web Announcement 3894.

    Top Prior Authorization Denial Reasons for the First Quarter of 2026. See Web Announcement 3900.

    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
... may have been provided in a previous payment. 5071 POSS CON: PT56 MED REHAB LTAC SPEC 5005 CLAIM/DETAIL CONFLICTS WITH A B20 Procedure/service was ...
Terms matched: 1  -  Score: 21  -  06 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
2. NV_BillingGuidelines_PT87.pdf
... Portal using the FA-11 form and should be submitted with a process type of BH Rehab. 03/17/2026 Provider Type 87 Billing Guide 1/5 ...
Terms matched: 1  -  Score: 23  -  17 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT87.pdf
3. NV_EVS_User_Manual_Ch4.pdf
... • BH Outpt • PCS One-Time • Retro BH Rehab • BH PHP/IOP • PCS SDS †...
Terms matched: 1  -  Score: 50  -  15 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch4.pdf
4. web_announcement_3740_20251010.pdf
... Health) • 17 (Special Clinics) specialty 183 (Comprehensive Outpatient Rehab Facilities (CORF)) • 17 (Special Clinics) specialty ...
Terms matched: 1  -  Score: 20  -  10 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3740_20251010.pdf
5. web_announcement_Volume 22 Issue 3_20250930.pdf
... Health) • 17 (Special Clinics) specialty 183 (Comprehensive Outpatient Rehab Facilities (CORF)) • 17 (Special Clinics) specialty ...
Terms matched: 1  -  Score: 13  -  30 Sep 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_Volume%2022%20Issue%203_20250930.pdf
6. web_announcement_3701_20250825.pdf
... Health) • 17 (Special Clinics) specialty 183 (Comprehensive Outpatient Rehab Facilities (CORF)) • 17 (Special Clinics) specialty ...
Terms matched: 1  -  Score: 20  -  15 Sep 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3701_20250825.pdf
7. FA-29A.pdf
... Behavioral Health Dental/Orthodontia DME Home Health Inpatient Medical/Surgical Inpatient LTAC Inpatient Rehab Outpatient Medical/Surgical Outpatient Rehab Outpatient Therapy PRTF SECTION II: REQUEST Terminate ...
Terms matched: 1  -  Score: 41  -  16 Jul 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-29A.pdf
8. FA-16B.pdf
... trach: ï No ventilator, BiPap or CPAP ï patent airway ï Ventilator: rehab transition / active weaning ï unstable airway with desaturations, and airway clearance ï ...
Terms matched: 1  -  Score: 12  -  20 Jun 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-16B.pdf
9. 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
10. web_announcement_3489_20241126.pdf
... 5619 no longer apply to the following procedure codes: • 92510 (Rehab for ear implant) • 97124 (Massage therapy) †...
Terms matched: 1  -  Score: 23  -  26 Nov 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3489_20241126.pdf
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