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.
Email: nvmmis.edisupport
@gainwelltechnologies.com
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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

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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_Billing_General_20251017.pdf
... ) 942-6511 Swipe Card System A recipient’s Medicaid card includes a magnetic strip on the back. When used with a swipe card system, this magnetic ...
Terms matched: 1  -  Score: 22  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20251017.pdf
2. NV_Billing_General_20251215.pdf
... ) 942-6511 Swipe Card System A recipient’s Medicaid card includes a magnetic strip on the back. When used with a swipe card system, this magnetic ...
Terms matched: 1  -  Score: 22  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20251215.pdf
3. NV_Billing_General.pdf
... ) 942-6511 Swipe Card System A recipient’s Medicaid card includes a magnetic strip on the back. When used with a swipe card system, this magnetic ...
Terms matched: 1  -  Score: 22  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
4. NV_BillingGuidelines_PT33_20250623.pdf
... 2020, diabetic equipment and supplies including but not limited to: glucometers, test strips, lancets/lancet devices, insulin syringes, reagents, insulin pumps and ...
Terms matched: 1  -  Score: 12  -  15 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT33_20250623.pdf
5. NV_BillingGuidelines_PT33.pdf
... 2020, diabetic equipment and supplies including but not limited to: glucometers, test strips, lancets/lancet devices, insulin syringes, reagents, insulin pumps and ...
Terms matched: 1  -  Score: 12  -  15 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT33.pdf
6. NV_Billing_General_20250801.pdf
... ) 942-6511 Swipe Card System A recipient’s Medicaid card includes a magnetic strip on the back. When used with a swipe card system, this magnetic ...
Terms matched: 1  -  Score: 23  -  17 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20250801.pdf
7. web_announcement_3727_20250918.pdf
... OMNIPOD 5 G6/LIBRE 2 Added to Preferred List PLUS PODS 65702-0711-10 Blood Glucose Strips ACCU-CHEK GUIDE Added to Preferred List 65702-0712-10 TEST STRIP ACCU-CHEK 65702-0492-10 Blood Glucose Strips ...
Terms matched: 1  -  Score: 153  -  18 Sep 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3727_20250918.pdf
8. web_announcement_3726_20250918.pdf
... , 2025 Web Announcement 3726 Changes made to coverage of OneTouch® meters and test strips, effective 9/15/2025 Effective 9/15/2025, ...
Terms matched: 1  -  Score: 310  -  18 Sep 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3726_20250918.pdf
9. NV_Billing_General_20250220.pdf
... ) 942-6511 Swipe Card System A recipient’s Medicaid card includes a magnetic strip on the back. When used with a swipe card system, this magnetic ...
Terms matched: 1  -  Score: 23  -  29 Jul 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20250220.pdf
10. NV_BillingGuidelines_PT33_20240523.pdf
... 2020, diabetic equipment and supplies including but not limited to: glucometers, test strips, lancets/lancet devices, insulin syringes, reagents, insulin pumps and ...
Terms matched: 1  -  Score: 12  -  23 Jun 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT33_20240523.pdf
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