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:
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    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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101. Hospice_Authorization_-_Claim_Training_021518.pdf
... “Formsâ€page, locate the “Hospice Formsâ€section and choose appropriate forms. †' Make sure that you follow the instructions on ...
Terms matched: 1  -  Score: 13  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Hospice_Authorization_-_Claim_Training_021518.pdf
102. Health_Care_Premium_Payment_(820)_n062818 draft.pdf
... Data (Subscriber Information 2100 C Loop) An 820 transaction is created for each MCO and payment for each recipient that is enrolled in the MCO for the following ...
Terms matched: 1  -  Score: 24  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Health_Care_Premium_Payment_(820)_n062818%20draft.pdf
103. Health_Care_Premium_Payment_(820)_-_Mod.pdf
... Data (Subscriber Information 2100 C Loop) An 820 transaction is created for each MCO and payment for each recipient that is enrolled in the MCO for the following ...
Terms matched: 1  -  Score: 24  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Health_Care_Premium_Payment_(820)_-_Mod.pdf
104. Foundations-New Provider Program Basics 2015-0921.pdf
... HP Enterprise Services (HPES) • Nevada Medicaid Managed Care Organizations (MCO) • Questions? 2 Foundations: New Provider Program Basics Department ...
Terms matched: 1  -  Score: 23  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Foundations-New%20Provider%20Program%20Basics%202015-0921.pdf
105. Final_Introduction_to_Nevada_Medicaid_and_Check_Up_2012-0801.pdf
... €¢ Recipients have 30 days to choose an MCO before one is assigned to ... Program requires the mandatory enrollment in an MCO of some recipients found eligible for Medicaid ...
Terms matched: 2  -  Score: 200  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Final_Introduction_to_Nevada_Medicaid_and_Check_Up_2012-0801.pdf
106. FA-57.pdf
... provider, etc.) for billing purposes. In addition, the facility may choose to obtain their own certification for their billing purposes. FA-57 Page 1 of ...
Terms matched: 1  -  Score: 20  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-57.pdf
107. FA-50.pdf
... . The physician (surgeon) must sign in this space. Section III: Choose A, B, C, or D if patient is already sterile or ...
Terms matched: 1  -  Score: 20  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-50.pdf
108. FA-17.pdf
... ) Requested number of days per week: Total Units Requested: ICD-10 Code: Choose one: S5102 (Attends 6 or more hours per day) S5100 ( ...
Terms matched: 1  -  Score: 44  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-17.pdf
109. FA-17-I.pdf
... number of days per week. d) Indicate the ICD-10 code. e) Choose one of the two HCPCS codes (S5012 or S5100) for the services ...
Terms matched: 1  -  Score: 36  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-17-I.pdf
110. Exondys_51_2017-0314.pdf
... . Particular care needs to be taken with such patients in deciding which glucocorticoid to choose, when to initiate treatment, and how best to monitor the child for ...
Terms matched: 1  -  Score: 12  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Exondys_51_2017-0314.pdf
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