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. 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
... /9 /2019 5/20/2019 N/A Type 44 (Swing providers to submit with Type of Bill 0281- • After the ...
Terms matched: 1  -  Score: 12  -  06 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
3. Error_Code_to_EOB_to_ANSI.pdf
... same/similar procedure within set time frame. 5002 POSS CONFLICT: PT44 (SWING BED 5002 CLAIM/DETAIL CONFLICTS WITH A 97 The benefit for this service ...
Terms matched: 1  -  Score: 11  -  06 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
4. NV_BillingGuidelines_PT11_online_082725.pdf
... care. Refer to MSM Chapter 400 for the inpatient mental health services policy. Swing beds (Medicare Certified in rural or critical access hospitals only) Refer to ...
Terms matched: 1  -  Score: 24  -  01 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT11_online_082725.pdf
5. NV_BillingGuidelines_PT11.pdf
... care. Refer to MSM Chapter 400 for the inpatient mental health services policy. Swing beds (Medicare Certified in rural or critical access hospitals only) Refer to ...
Terms matched: 1  -  Score: 24  -  01 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT11.pdf
6. Team_Territories.pdf
... ¢ 29 â€" Home Health Agency • 44 â€" Swing Bed, Acute Hospital • 45 â€" End Stage Renal ...
Terms matched: 1  -  Score: 20  -  06 Jan 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Team_Territories.pdf
7. NV_BillingGuidelines_PT33_20250623.pdf
... tubs or Jacuzzis® • Personal computers • Playground equipment (swings, jungle gyms, tunnels, parachutes, obstacle courses) • ...
Terms matched: 1  -  Score: 12  -  15 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT33_20250623.pdf
8. NV_BillingGuidelines_PT33.pdf
... tubs or Jacuzzis® • Personal computers • Playground equipment (swings, jungle gyms, tunnels, parachutes, obstacle courses) • ...
Terms matched: 1  -  Score: 12  -  15 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT33.pdf
9. NV_BillingGuidelines_PT11_online_050625.pdf
... of care. Refer to MSM Chapter 400, Section 403.9 for additional information. Swing beds (Medicare Certified in rural or critical access hospitals only) Refer to ...
Terms matched: 1  -  Score: 24  -  27 Aug 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT11_online_050625.pdf
10. NV_BillingGuidelines_PT33_20240523.pdf
... tubs or Jacuzzis® • Personal computers • Playground equipment (swings, jungle gyms, tunnels, parachutes, obstacle courses) • ...
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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