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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NOTIFICATION: The Provider Pre-Admission Screening Resident Review (PASRR) service will be unavailable from 8 p.m. to midnight Pacific Time on Monday, January 12, 2026, for scheduled maintenance.

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 November 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. 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
2. Encounter-Dental_837D_MCO_Companion_Guide_-_Mod.pdf
... , LM, MA, MB, MC, OF, TV, VA, WC, ZZ Medicaid MC 2 The value sent at this level should always be ...
Terms matched: 1  -  Score: 21  -  06 Feb 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Encounter-Dental_837D_MCO_Companion_Guide_-_Mod.pdf
3. Encounter-Institutional_837I_MCO_Companion_Guide_-_Mod.pdf
... , LM, MA, MB, MC, OF, TV, VA, WC, ZZ Medicaid MC 2 The value sent at this level should always be ...
Terms matched: 1  -  Score: 21  -  06 Feb 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Encounter-Institutional_837I_MCO_Companion_Guide_-_Mod.pdf
4. Encounter-Professional_837P_MCO_Companion_Guide_-_Mod.pdf
... , LM, MA, MB, MC, OF, TV, VA, WC, ZZ Medicaid MC 2 The value sent at this level should always be ...
Terms matched: 1  -  Score: 11  -  06 Feb 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Encounter-Professional_837P_MCO_Companion_Guide_-_Mod.pdf
5. Professional_FFS_837P.pdf
... , LM, MA, MB, MC, OF, TV, VA, WC, ZZ Medicaid MC 2 121 2010BA NM1 Subscriber Name Updated 01/06 ...
Terms matched: 1  -  Score: 11  -  06 Jan 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Professional_FFS_837P.pdf
6. Inhaled Antimuscarinics 2012 12.pdf
... . 25. van Noord JA, de Munck DR, Bantje TA, Hop WC, Akveld ML, Bommer AM. Long-term treatment of chronic obstructive pulmonary disease ...
Terms matched: 1  -  Score: 28  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Inhaled%20Antimuscarinics%202012%2012.pdf
7. Inhaled Anticholinergics_09222016.pdf
... . 55. van Noord JA, de Munck DR, Bantje TA, Hop WC, Akveld ML, Bommer AM. Long-term treatment of chronic obstructive pulmonary disease ...
Terms matched: 1  -  Score: 12  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Inhaled%20Anticholinergics_09222016.pdf
8. Inhaled Anticholinergics.pdf
... . 55. van Noord JA, de Munck DR, Bantje TA, Hop WC, Akveld ML, Bommer AM. Long-term treatment of chronic obstructive pulmonary disease ...
Terms matched: 1  -  Score: 28  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Inhaled%20Anticholinergics.pdf
9. Immunomodulators_2015-0930.pdf
... :253-61. 126. He Y, Wong AY, Chan EW, Lau WC, Man KK, Chui CS, et al. Efficacy and safety of ...
Terms matched: 1  -  Score: 28  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Immunomodulators_2015-0930.pdf
10. Immunomodulators_2016-12.pdf
... :253-61. 156. He Y, Wong AY, Chan EW, Lau WC, Man KK, Chui CS, et al. Efficacy and safety of ...
Terms matched: 1  -  Score: 12  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Immunomodulators_2016-12.pdf
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