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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Top 10 Claim Denial Reasons and Resolutions/Workarounds for February 2026 Professional Claims. See Web Announcement 3863.

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 https://NevadaMedicaid.nv.gov/ and the Billing Guide for your provider type at www.medicaid.nv.gov.

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1. NV_BillingGuidelines_PT22-attachmentA_01-29-26.pdf
... A MEDICAL HEALTH 00 00 00 1 unit per 6 months CARE PROFESSIONAL D9410 DENTAL HOUSE CALL 00 00 00 D9420 HOSPITAL CALL 00 00 00 D9440 OFFICE VISIT AFTER ...
Terms matched: 1  -  Score: 12  -  23 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentA_01-29-26.pdf
2. NV_BillingGuidelines_PT22-attachmentA.pdf
... A MEDICAL HEALTH 00 00 00 1 unit per 6 months CARE PROFESSIONAL D9410 DENTAL HOUSE CALL 00 00 00 D9420 HOSPITAL CALL 00 00 00 D9440 OFFICE VISIT AFTER ...
Terms matched: 1  -  Score: 12  -  23 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentA.pdf
3. NV_BillingGuidelines_PT87_Spec250_090324.pdf
... Coordinate connection to ongoing care. CSC case management services will assist patients to obtain housing, food, primary health care and other basic needs along with the coordination ...
Terms matched: 1  -  Score: 20  -  17 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT87_Spec250_090324.pdf
4. NV_Billing_General.pdf
... the request to Nevada Medicaid. • If the patient is still in house, Nevada Medicaid reviews the request in the same time frame as any other ...
Terms matched: 1  -  Score: 31  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General.pdf
5. NV_Billing_General_20260101.pdf
... the request to Nevada Medicaid. • If the patient is still in house, Nevada Medicaid reviews the request in the same time frame as any other ...
Terms matched: 1  -  Score: 22  -  20 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20260101.pdf
6. NV_EVS_User_Manual_Ch1.pdf
... an available provider, Dr. David Green. By checking on David Green, ... ¢ Office Administrator • Clearing House • Health Maintenance †...
Terms matched: 2  -  Score: 35  -  18 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EVS_User_Manual_Ch1.pdf
7. NV_BillingGuidelines_PT22-attachmentB.pdf
... 00 increment D9248 Non-intravenous conscious sedation 00 6 units per 12 rolling months D9410 Dental house call 2 service units per 6 months. D9410 must document 00 appropriate CDT ...
Terms matched: 1  -  Score: 12  -  02 Feb 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentB.pdf
8. NV_Billing_General_20251017.pdf
... the request to Nevada Medicaid. • If the patient is still in house, Nevada Medicaid reviews the request in the same time frame as any other ...
Terms matched: 1  -  Score: 22  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20251017.pdf
9. NV_Billing_General_20251215.pdf
... the request to Nevada Medicaid. • If the patient is still in house, Nevada Medicaid reviews the request in the same time frame as any other ...
Terms matched: 1  -  Score: 22  -  31 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20251215.pdf
10. NV_BillingGuidelines_PT60.pdf
... health care professional. • Limit of 1 unit per 6 months D9410 House/extended care facility call. D9420 Hospital or ambulatory surgical center call. ...
Terms matched: 1  -  Score: 10  -  16 Dec 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60.pdf
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