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 June 2026 Professional Claims. See Web Announcement 3964.

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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... Type in their answer to the Challenge 4 Question to verify identity 5 4. Choose whether log in is on a personal computer or public computer 5. Click ...
Terms matched: 1  -  Score: 68  -  24 Apr 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Dental_and_Orthodontia_Training_042419.pdf
... Options This section describes the connectivity options from which a Trading Partner will need to choose for the submission of transactions. Nevada Medicaid supports multiple methods for exchanging electronic ...
Terms matched: 1  -  Score: 68  -  29 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Trading_Partner_User_Guide.pdf
... Options This section describes the connectivity options from which a Trading Partner will need to choose for the submission of transactions. Nevada Medicaid supports multiple methods for exchanging electronic ...
Terms matched: 1  -  Score: 68  -  20 Jan 2023  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EDI_Trading_Partner_User_Guide.pdf
... Medicaid does not place a limit on the number of covered days. The 180-day MCO coverage requirement applies to every nursing facility admission, regardless of the recipient receiving ...
Terms matched: 1  -  Score: 68  -  27 Sep 2023  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_3175_20230927.pdf
... also reimbursed in facilities enrolled with DHCFP that have swing bed licensure and certification. MCO vs. FFS When a recipient is enrolled in a Managed Care Organization ( ...
Terms matched: 1  -  Score: 66  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT75_online_022715.pdf
... also reimbursed in facilities enrolled with DHCFP that have swing bed licensure and certification. MCO vs. FFS When a recipient is enrolled in a Managed Care Organization ( ...
Terms matched: 1  -  Score: 66  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT75_online_070314.pdf
... within 6 months of discontinuation (Level A) . Physicians and people with MS choosing to switch from natalizumab to ï ngolimod should initiate treatment within 8 to 12 ...
Terms matched: 1  -  Score: 66  -  26 Mar 2021  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FFS_DUR_Binder_April_2021.pdf
... also reimbursed in facilities enrolled with DHCFP that have swing bed licensure and certification. MCO vs. FFS When a recipient is enrolled in a Managed Care Organization ( ...
Terms matched: 1  -  Score: 66  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT75_online_110813.pdf
... also reimbursed in facilities enrolled with DHCFP that have swing bed licensure and certification. MCO vs. FFS When a recipient is enrolled in a Managed Care Organization ( ...
Terms matched: 1  -  Score: 66  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT75_online_012815.pdf
... Nevada Check-Up Recipients Nevada Check-Up recipients are not disenrolled from a Managed Care Organization (MCO) when they receive hospice services. Although Nevada Check Up recipients receiving hospice ...
Terms matched: 1  -  Score: 66  -  16 Jan 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT64.pdf
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