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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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 July 2026 Professional Claims. See Web Announcement 3983.

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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181. NV_BillingGuidelines_PT22_20090801.pdf
... and recipient is transitioned to a Managed Care routine maintenance to promote dental Organization (MCO) at the beginning of health. their second full month of eligibility. ...
Terms matched: 1  -  Score: 100  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22_20090801.pdf
182. NV_BillingGuidelines_PT22_20080827.pdf
... and recipient is transitioned to a Managed Care routine maintenance to promote dental Organization (MCO) at the beginning of health. their second full month of eligibility. ...
Terms matched: 1  -  Score: 100  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22_20080827.pdf
183. ABA_Provider_Training_041219.pdf
... continued • While on the “Formsâ€page, locate and choose appropriate forms • Make sure that all instructions are followed †...
Terms matched: 1  -  Score: 97  -  12 Apr 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/ABA_Provider_Training_041219.pdf
184. Behavioral_Health_Training_032819.pdf
... Authorization Forms, continued • While on the Forms page, locate and choose appropriate forms • Make sure that instructions are followed • ...
Terms matched: 1  -  Score: 97  -  28 Mar 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Behavioral_Health_Training_032819.pdf
185. Trading Partners Fully Certified Report.pdf
... Home Companion X X ANGEL’S TOUCH HOME CARE LLC X Anthem (MCO) X X Apex EDI X X X Availity, LLC X X X ...
Terms matched: 1  -  Score: 96  -  21 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Trading%20Partners%20Fully%20Certified%20Report.pdf
186. Trading%20Partners%20Fully%20Certified%20Report.pdf
... Home Companion X X ANGEL’S TOUCH HOME CARE LLC X Anthem (MCO) X X Apex EDI X X X Availity, LLC X X X ...
Terms matched: 1  -  Score: 96  -  06 Jan 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Trading%2520Partners%2520Fully%2520Certified%2520Report.pdf
187. Trading_Partners_Fully_Certified_Report.pdf
... Home Companion X X ANGEL’S TOUCH HOME CARE LLC X Anthem (MCO) X X Apex EDI X X X Availity, LLC X X X ...
Terms matched: 1  -  Score: 96  -  02 May 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Trading_Partners_Fully_Certified_Report.pdf
188. NV_BillingGuidelines_PT22_20100630.pdf
... the recipient is transitioned to a certain restorative services and routine Managed Care Organization (MCO) at the maintenance to promote dental health. beginning of their second full ...
Terms matched: 1  -  Score: 95  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22_20100630.pdf
189. Health_Plan_of_Nevada_DUR_Binder_April_2021.pdf
... Drug Use Review Board Meeting APRIL 22, 2021 2021 3 DRUG USE REVIEW BOARD MCO PRIOR AUTHORIZATION CRITERIA REVIEW FORM Clinical criteria for drugs or drug classes listed on ...
Terms matched: 1  -  Score: 94  -  02 Apr 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Health_Plan_of_Nevada_DUR_Binder_April_2021.pdf
190. Nevada Provider Training - Institutional.pdf
... . Select a Site Key image 8. Enter a unique Passphrase 8 9. Choose 3 Challenge Questions from the 9 dropdown list and create a unique answer for ...
Terms matched: 1  -  Score: 94  -  01 Feb 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Nevada%20Provider%20Training%20-%20Institutional.pdf
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