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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NOTIFICATION: The following Nevada Medicaid Provider Web Portal services will be unavailable from 4 p.m. Pacific Time on Sunday, October 11, 2026, through 3 a.m. Pacific Time on Monday, October 12, 2026, for scheduled maintenance:
  • All secure Provider Web Portal (PWP) functions
  • Provider Flex
  • Real time CAQH/CORE EDI eligibility and claim verification
  • Provider Pre-Admission Screening Resident Review (PASRR)

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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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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171. web_announcement_1265_20161110.pdf
... Medicaid or Nevada Check Up recipients, including both Fee-for-Service and Managed Care Organization (MCO) enrolled recipients. You will also not have access to the Provider Web ...
Terms matched: 1  -  Score: 20  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_1265_20161110.pdf
172. web_announcement_301_20091230.pdf
... Ill (SMI) may elect to disenroll from the Medicaid Managed Care Organization (MCO) program. However, the recipient must be redetermined as SED or SMI ...
Terms matched: 1  -  Score: 87  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_301_20091230.pdf
173. NV_BillingGuidelines_PT38_20090501.pdf
... Churchill. Coordinator who is responsible for developing his or her Individual Support Recipients who choose self-directed services Plan (ISP) . will be assisted by a Financial Management ...
Terms matched: 1  -  Score: 20  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT38_20090501.pdf
174. web_announcement_655_20131021.pdf
... when a managed care recipient is allowed to switch from one Managed Care Organization (MCO) to the other. Previously, a recipient (with no other household ...
Terms matched: 1  -  Score: 102  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_655_20131021.pdf
175. web_announcement_759_20140623.pdf
... date for the exiting agency. Recipients who request a transfer but require assistance to choose a new agency will be directed to their local Nevada Medicaid District Office for ...
Terms matched: 1  -  Score: 20  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_759_20140623.pdf
176. web_announcement_50_041805.pdf
... scheduled for following month after the recipient has transitioned to a Managed Care Organization (MCO) . Commencing with date of service June 1, 2005, we will ...
Terms matched: 1  -  Score: 36  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_50_041805.pdf
177. web_announcement_1107_20160328.pdf
... To complete changes online, please login to the secure Provider Web Portal, and choose “Revalidate-Update Providerâ€or use the Provider Information Change Form (FA-33 ...
Terms matched: 1  -  Score: 20  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_1107_20160328.pdf
178. web_announcement_1114_20160406.pdf
... complete provider changes online, please login to the secure Provider Web Portal, and choose “Revalidate-Update Providerâ€or use the Provider Information Change Form (FA-33 ...
Terms matched: 1  -  Score: 20  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_1114_20160406.pdf
179. web_announcement_1331_20170327.pdf
... 27, 2017 Announcement 1331 Attention All Nevada Medicaid Providers: Managed Care Organization (MCO) Changes Effective 2017 Effective July 1, 2017, the Division of Health ...
Terms matched: 1  -  Score: 168  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_1331_20170327.pdf
180. web_announcement_1205_20160816.pdf
... Medicaid or Nevada Check Up recipients, including both Fee-for-Service and Managed Care Organization (MCO) enrolled recipients. ï ‚ The provider will need to submit a new ...
Terms matched: 1  -  Score: 20  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_1205_20160816.pdf
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