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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NOTIFICATION: The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. Pacific Time on Monday, May 11, 2026, through 4 a.m. Pacific Time on Tuesday, May 12, 2026, for scheduled maintenance:
  • All secure Provider Web Portal (PWP) functions
  • Provider Flex
  • Gabby®, which includes:
    • Gainwell Technologies Contact Center (877) 638-3472
    • Automated Response System (ARS) (800) 942-6511
  • Real time CAQH/CORE EDI eligibility and claim verification
  • Provider Pre-Admission Screening Resident Review (PASRR)
    • Known System Issues-Click HERE

    Top 10 Claim Denial Reasons and Resolutions/Workarounds for March 2026 Professional Claims. See Web Announcement 3894.

    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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During the scheduled site maintenance window the Provider Web Portal will be unavailable. The table below shows the regularly scheduled maintenance window. All times will be in the Pacific time zone.

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1. Known_Issues.pdf
... how to correctly submit Centers claims in chronological order per approved prior authorization lines. 120 Claims, Some claims submitted by Provider Type 14- • Provider ...
Terms matched: 1  -  Score: 11  -  06 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
2. Error_Code_to_EOB_to_ANSI.pdf
... Information REF), if present. Updated: 05/05/2026 Page 120 of 185 Claim Error/EOB/ANSI Code Crosswalk ERROR_CODE ERROR_CODE_DESCRIPTION EOB_CODE EOB_CODE_DESCRIPTION ...
Terms matched: 1  -  Score: 38  -  06 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
3. Provider_Enrollment_Information_Booklet.pdf
... • 119: Head/Neck Surgery Rare Diseases Clinic • 120: Hematology • 820: Physician, M.D., †...
Terms matched: 1  -  Score: 26  -  21 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
4. NV_EVS_User_Manual_Ch1.pdf
... Event Calendar will show information up to 30 days into the past and up to 120 days into the future. 1. Navigate back and forth between the months ...
Terms matched: 1  -  Score: 14  -  18 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch1.pdf
5. web_announcement_3711_20250904.pdf
... ), Nevada Medicaid Place of Meeting: Nevada Medicaid 1919 College Parkway, Suite 120 Carson City, Nevada 89706 Please use the teleconference/Microsoft Teams options provided ...
Terms matched: 1  -  Score: 47  -  04 Sep 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3711_20250904.pdf
6. NV_BillingGuidelines_PT29.pdf
... continue services. This period combined with the initial authorization period may be up to 120 days total. Updated 07/09/2025 Provider Type 29 Billing Guide ...
Terms matched: 1  -  Score: 41  -  09 Jul 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT29.pdf
7. NV_BillingGuidelines_PT29_online_20250318.pdf
... continue services. This period combined with the initial authorization period may be up to 120 days total. Updated 03/18/2025 Provider Type 29 Billing Guide ...
Terms matched: 1  -  Score: 41  -  09 Jul 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT29_online_20250318.pdf
8. NV_BillingGuidelines_PT29_online_20240411.pdf
... continue services. This period combined with the initial authorization period may be up to 120 days total. Updated 04/11/2024 Provider Type 29 Billing Guide ...
Terms matched: 1  -  Score: 41  -  18 Mar 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT29_online_20240411.pdf
9. NV_Provider_Enrollment_Information_Booklet.pdf
... to the revalidation due date. Provider revalidation notices are emailed and mailed to providers 120, 90, 60 and 20 days prior to their revalidation due date. ...
Terms matched: 1  -  Score: 31  -  14 Mar 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Provider_Enrollment_Information_Booklet.pdf
10. 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
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