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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Top 10 Claim Denial Reasons and Resolutions/Workarounds for April 2026 Professional Claims. See Web Announcement 3915.

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. Pregnancy_Presumptive_Eligibility_Instructions.pdf
... identified employee staff. The Presumptive Eligibility Pregnancy course is approximately 12 hours via an online forum. Allowable Services Medicaid coverage during the presumptive eligibility period is limited to ...
Terms matched: 1  -  Score: 21  -  15 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Pregnancy_Presumptive_Eligibility_Instructions.pdf
2. 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
3. Known_Issues.pdf
... 19/2019 N/A Enrollment, API (API) cannot access the Online Provider a revalidation and/or change/update. If Enrollment (OPE ...
Terms matched: 1  -  Score: 56  -  06 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
4. NV_BillingGuidelines_PT11_online_082725.pdf
... NV BillingGuidelines PT11 online 082725 ...
Terms matched: 1  -  Score: 16  -  01 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT11_online_082725.pdf
5. NV_BillingGuidelines_PT60_2025-1216.pdf
... list of covered codes and the current Nevada Medicaid rates. The fee schedule is online at http://dhcfp.nv.gov/Resources/Rates/FeeSchedules/ . ...
Terms matched: 1  -  Score: 14  -  29 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60_2025-1216.pdf
6. NV_BillingGuidelines_PT60.pdf
... list of covered codes and the current Nevada Medicaid rates. The fee schedule is online at https://www.nevadamedicaid.nv.gov/resources/rates/fee-schedules/ . ...
Terms matched: 1  -  Score: 14  -  29 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60.pdf
7. Provider_Enrollment_Information_Booklet.pdf
... Checklist for each provider type. Preparing all required enrollment information prior to beginning an online application reduces the likelihood of a returned application. Visit the Nevada Medicaid YouTube ...
Terms matched: 1  -  Score: 29  -  21 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
8. NV_BillingGuidelines_PT65_online_20230126.pdf
... NV BillingGuidelines PT65 online 20230126 ...
Terms matched: 1  -  Score: 16  -  20 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT65_online_20230126.pdf
9. FA-30-I.pdf
... providers may contact the OOS facility for placement coordination. Finding the Form and Instructions Online Form FA-30 and these instructions are online at www.medicaid.nv.gov (select “Formsâ ...
Terms matched: 1  -  Score: 52  -  16 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-30-I.pdf
10. NV_BillingGuidelines_PT20-24-77_online_011226_to_040326.pdf
... guide by service type for PA requirements. All Fee-for-Service prior authorizations must be submitted online through the Provider Web Portal at www.medicaid.nv.gov. Any necessary forms are available on ...
Terms matched: 1  -  Score: 31  -  03 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT20-24-77_online_011226_to_040326.pdf
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