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 June 2026 Professional Claims. See Web Announcement 3964.

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. 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
2. Known_Issues.pdf
... denying incorrectly with error code 1009-(Contract could not be determined) . 150 Claims, Other Some claims submitted between the dates of • Providers ...
Terms matched: 1  -  Score: 11  -  06 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
3. Error_Code_to_EOB_to_ANSI.pdf
... Service Payment Information REF), if present. 248 PLACE OF SERVICE INVALID FORMAT 150 Place of Service is Missing or Invalid 16 Claim/service lacks information or ...
Terms matched: 1  -  Score: 38  -  06 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
4. Provider_Enrollment_Information_Booklet.pdf
... €¢ 149: Pulmonary Diseases • 105: Burns • 150: Radiation Therapy • 106: Cardiovascular • 151: ...
Terms matched: 1  -  Score: 14  -  21 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
5. web_announcement_3753_20251024.pdf
... Star or Sam’s Club, $200 for daycare services, $150 for swim Anthem lessons, home-delivered meals for pregnant and new moms, employment ...
Terms matched: 1  -  Score: 14  -  24 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3753_20251024.pdf
6. web_announcement_3640_20250521.pdf
... the reimbursement to a flat rate of $800 with the possibility of a $150 add-on option for intensive treatment services for children under age 10 and/or ...
Terms matched: 1  -  Score: 23  -  21 May 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3640_20250521.pdf
7. NV_Provider_Enrollment_Information_Booklet.pdf
... ¢ 149: Pulmonary Diseases • 118: Hand Surgery • 150: Radiation Therapy • 119: Head/Neck Surgery †...
Terms matched: 1  -  Score: 12  -  14 Mar 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Provider_Enrollment_Information_Booklet.pdf
8. 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
9. NV_BillingGuidelines_PT38_20240917.pdf
... Limits The following limits apply to covered services: • T2003: $150 per month • T2019 TG or T2019 TG, TN: 216 ...
Terms matched: 1  -  Score: 20  -  27 Dec 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT38_20240917.pdf
10. NV_BillingGuidelines_PT38.pdf
... Limits The following limits apply to covered services: • T2003: $150 per month • T2019 TG or T2019 TG, TN: 216 ...
Terms matched: 1  -  Score: 20  -  27 Dec 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT38.pdf
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