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.
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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 Fourth Quarter of 2025. See Web Announcement 3830.

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_3753_20251024.pdf
... Boys & Girls Club membership, MeetMolina.com/nv-medicaid support for pregnant members (baby shower, car/booster seat, meals) . Gym membership; transportation or ...
Terms matched: 1  -  Score: 13  -  24 Oct 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3753_20251024.pdf
2. 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
3. HMG CoA Reductase Inhibitors.pdf
... 3 ): 427-37. 104. Crouse JR 3rd, Raichlen JS, Riley WA, Evans GW, Palmer MK, O'Leary DH, et al. Effect ...
Terms matched: 1  -  Score: 10  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/HMG%20CoA%20Reductase%20Inhibitors.pdf
4. HMG_CoA_Reductase_Inhibitors_2013-0812.pdf
... 3 ): 427-37. 104. Crouse JR 3rd, Raichlen JS, Riley WA, Evans GW, Palmer MK, O'Leary DH, et al. Effect ...
Terms matched: 1  -  Score: 10  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/HMG_CoA_Reductase_Inhibitors_2013-0812.pdf
5. FA-24_NMO-All_PCS_Assessment_Forms_Bundle.pdf
... lifestyle choices. A. Bathing: Bathing or washing the recipient whether tub/shower/bed. Includes entering tub/ Bathing/Dressing/Grooming shower, ...
Terms matched: 1  -  Score: 87  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-24_NMO-All_PCS_Assessment_Forms_Bundle.pdf
6. FA-24_NMO-3244_NMO-3241.pdf
... lifestyle choices. A. Bathing: Bathing or washing the recipient whether tub/shower/bed. Includes entering tub/ Bathing/Dressing/Grooming shower, ...
Terms matched: 1  -  Score: 87  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-24_NMO-3244_NMO-3241.pdf
7. E-Binder_PT_September_2018.pdf
... JR 3rd, Raichlen JS, Riley WA, et al. Effect of rosuvastatin ... by washing or minutes using the lowest showering. strength possible for at least one ...
Terms matched: 2  -  Score: 21  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_PT_September_2018.pdf
8. E-Binder_PT_September_2017.pdf
... JR 3rd, Raichlen JS, Riley WA, et al. Effect of rosuvastatin ... by washing or minutes using the lowest showering. strength possible for at least one ...
Terms matched: 2  -  Score: 42  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_PT_September_2017.pdf
9. E-Binder_PT_March_2018.pdf
... ) . August 2017. ï ‚ Crouse JR 3rd, Raichlen JS, Riley WA, et al. Effect of rosuvastatin on progression of carotid intima-media thickness in ...
Terms matched: 1  -  Score: 11  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_PT_March_2018.pdf
10. E-Binder_PT_December_2017.pdf
... Topical Twice daily or damaged skin; should not be epolamine worn while bathing or showering patch) Pennsaid Apply to clean, dry skin; do not (diclofenac ...
Terms matched: 1  -  Score: 11  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_PT_December_2017.pdf
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