Nevada Medicaid and Nevada Check Up News (Third 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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Provider Flex is now LIVE for all provider types!
For information and training opportunities on this exciting new enrollment tool, please visit our Provider Flex page

Multi-Factor Authentication Frequently Asked Questions

Known System Issues-Click HERE

Top 10 Claim Denial Reasons and Resolutions/Workarounds for October 2025 Professional Claims. See Web Announcement 3767.

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. Known_Issues.pdf
... 2/6 /2019 2/19/2019 N/A Enrollment, API (API) cannot access the Online Provider a revalidation and/or change ...
Terms matched: 1  -  Score: 28  -  26 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
2. NV_Billing_General.pdf
... 2007 Large number of changes and updates including: All • NPI/API Updates • New Frequently Asked Questions throughout the manual • ...
Terms matched: 1  -  Score: 38  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
3. NV_Billing_General_20250801.pdf
... 2007 Large number of changes and updates including: All • NPI/API Updates • New Frequently Asked Questions throughout the manual • ...
Terms matched: 1  -  Score: 38  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20250801.pdf
4. NV_EVS_User_Manual_Ch8.pdf
... Number = Provider ID (National Provider Identifier/Atypical Provider Identifier [NPI/API])+ Recipient ID+ Date of Service+ Sequence Number (four ...
Terms matched: 1  -  Score: 52  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch8.pdf
5. NV_EVS_User_Manual_Ch3.pdf
... €¢ Reason for the appeal. • Provider name and NPI/API. • The claim’s ICN (claim number) ...
Terms matched: 1  -  Score: 24  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch3.pdf
6. NV_Billing_General_20250220.pdf
... 2007 Large number of changes and updates including: All • NPI/API Updates • New Frequently Asked Questions throughout the manual • ...
Terms matched: 1  -  Score: 38  -  29 Jul 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20250220.pdf
7. FA-24.pdf
... Code: Phone: PCS AGENCY INFORMATION PCS Agency Name: City: NPI/API: Phone: Fax: LEGALLY RESPONSIBLE INDIVIDUAL (LRI) INFORMATION (if ...
Terms matched: 1  -  Score: 23  -  16 Jul 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-24.pdf
8. FA-24W.pdf
... contact the recipient? Yes No PCS AGENCY INFORMATION PCS Agency Name: NPI/API: Phone #: CASE MANAGER INFORMATION (Enter the name and direct phone ...
Terms matched: 1  -  Score: 20  -  16 Jul 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-24W.pdf
9. FA-24C.pdf
... : Zip Code: Phone: ISO PROVIDER INFORMATION ISO Provider Name: NPI/API: Phone: Fax: FA-24C Authorization Request for Self-Directed Skilled Services Page 1 ...
Terms matched: 1  -  Score: 14  -  16 Jul 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-24C.pdf
10. Web_Portal_QRG_20120110.pdf
... €6) Enter required fields: First Name, Last Name, NPI/API, Tax ID and Zip Code (of the servicing provider); then ...
Terms matched: 1  -  Score: 23  -  15 Apr 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Web_Portal_QRG_20120110.pdf
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