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]

Notifications

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 September 2026 Professional Claims. See Web Announcement 4031.

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.

Scheduled Site Maintenance

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.

Monday - Friday
12:00AM - 12:30AM

Monday
8:00PM - 12:00AM

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... the retroactive time. Please note that this does not extend the timely filing policy set forth in Medicaid Services Manual Chapter 100 Medicaid Program. The list of claims ...
Terms matched: 1  -  Score: 28  -  19 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
... ,communication, interaction with peers or others in the environment or adjustment to the settings in which the recipient’s functions have diminished and update the anticipated ...
Terms matched: 1  -  Score: 58  -  14 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-11E.pdf
... contractual terms, limitations, exclusions, coordination of benefits and other terms and conditions set forth by the benefit program. The information contained in this form, including ...
Terms matched: 1  -  Score: 26  -  14 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-11.pdf
... contractual terms, limitations, exclusions, coordination of benefits and other terms and conditions set forth by the benefit program. The information contained in this form, including ...
Terms matched: 1  -  Score: 20  -  14 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-11B.pdf
... contractual terms, limitations and exclusions, coordination of benefits and other terms and conditions set forth by the benefit program. The information contained in this form, including ...
Terms matched: 1  -  Score: 20  -  14 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-11D.pdf
... contractual terms, limitations, exclusions, coordination of benefits and other terms and conditions set forth by the benefit program. The information on this form and on accompanying ...
Terms matched: 1  -  Score: 20  -  14 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-12.pdf
... the service is rendered, contractual terms, limitations, exclusions, terms & conditions set forth by the benefit program. The information contained on this form, including ...
Terms matched: 1  -  Score: 20  -  14 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-14.pdf
... contractual terms, limitations, exclusions, coordination of benefits and other terms and conditions set forth by the benefit program. Updated 10/13/2026 Provider Type ...
Terms matched: 1  -  Score: 27  -  13 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT85.pdf
... contractual terms, limitations, exclusions, coordination of benefits and other terms and conditions set forth by the benefit program. Updated 07/27/2026 Provider Type ...
Terms matched: 1  -  Score: 27  -  13 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT85_20260727.pdf
... /Recipient files Provider Each provider is responsible for: • Following regulations set forth in the Medicaid Services Manual (MSM) (see MSM Chapter 100 ...
Terms matched: 1  -  Score: 94  -  08 Oct 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20260710.pdf
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