Nevada Medicaid and Nevada Check Up News (Second 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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IMPORTANT: Nevada Medicaid is conducting a swift revalidation effort on high risk providers. If selected, you will receive a revalidation notice with instructions through the standard communication process. See Web Announcement 3935 for more information.

Known System Issues-Click HERE

Top 10 Claim Denial Reasons and Resolutions/Workarounds for August 2026 Professional Claims. See Web Announcement 4009.

Top Prior Authorization Denial Reasons for the Second Quarter of 2026. See Web Announcement 3978.

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. NV_Billing_General.pdf
... the Carson City and rural areas, call (775) 687-5162. For the Las Vegas area, call (702) 486-6200. For the Waiver for the ...
Terms matched: 1  -  Score: 31  -  08 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
2. NV_Billing_General_20260710.pdf
... the Carson City and rural areas, call (775) 687-5162. For the Las Vegas area, call (702) 486-6200. For the Waiver for the ...
Terms matched: 1  -  Score: 31  -  08 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20260710.pdf
3. web_announcement_4023_20261001.pdf
... Residential Treatment Facilities): Age Correction for Complex Case Criteria Correction to Web Announcement 3970: The special rate for private psychiatric residential treatment facilities (PRTF) for ...
Terms matched: 1  -  Score: 38  -  01 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_4023_20261001.pdf
4. web_announcement_3970_20260722.pdf
... July 22, 2026 (Updated October 1, 2026) Nevada Medicaid Web Announcement 3970 Attention Provider Type 63 (Psychiatric Residential Treatment Facility (PRTF)): ...
Terms matched: 1  -  Score: 38  -  01 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3970_20260722.pdf
5. NV_BillingGuidelines_PT29.pdf
... Nevada, the urban regions include Boulder City and the portion of Clark County within Las Vegas Valley including the cities of Las Vegas, North Las Vegas, Henderson ...
Terms matched: 1  -  Score: 50  -  28 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT29.pdf
6. web_announcement_3972_20260723.pdf
... , 2025. For additional information on this rate increase, please see Web Announcement 3970. Nevada Medicaid is making a one-time exception to reimburse providers at the reimbursement ...
Terms matched: 1  -  Score: 21  -  23 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3972_20260723.pdf
7. NV_Billing_General_20260220.pdf
... the Carson City and rural areas, call (775) 687-5162. For the Las Vegas area, call (702) 486-6200. For the Waiver for the ...
Terms matched: 1  -  Score: 31  -  10 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20260220.pdf
8. Benefit_Enrollment_and_Maintenance_(834).pdf
... LIBRA****34*546217345 N3*7878 RIO GRANDE N4*LAS VEGAS*NV*891300000**CY*002 DMG*D8* ...
Terms matched: 1  -  Score: 29  -  06 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Benefit_Enrollment_and_Maintenance_(834).pdf
9. Health_Care_Premium_Payment_(820).pdf
... N1*PE**FI*754480861 N3*PO BOX 15645 N4*LAS VEGAS*NV*891145645 N1*PR**FI*540849793 N3 ...
Terms matched: 1  -  Score: 12  -  06 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Health_Care_Premium_Payment_(820).pdf
10. Professional_FFS_837P.pdf
... ***XX*BILLPNPI123~ N3*BILL PROV STREET~ N4*LAS VEGAS*NV*891353324~ REF*EI*BILLTAXID~ HL* ...
Terms matched: 1  -  Score: 29  -  06 Jul 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Professional_FFS_837P.pdf
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