Nevada Medicaid and Nevada Check Up News (First Quarter 2025 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


Provider Flex is coming soon!
For information and training opportunities on this exciting new enrollment tool, please visit our Provider Flex page

Attention Provider Types 14 and 82:
Please note that the Online Provider Enrollment (OPE) tool will be unavailable to begin any NEW enrollment applications for these provider types from June 9, 2025 – June 16, 2025. Please refer to Web Announcement 3595 for details.

Multi-Factor Authentication Frequently Asked Questions

Known System Issues-Click HERE

Top 10 Claim Denial Reasons and Resolutions/Workarounds for March 2025 Professional Claims. See Web Announcement 3616.

Top Prior Authorization Denial Reasons for the First Quarter of 2025. See Web Announcement 3630.

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 dhcfp.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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... ; February 2021. • Post RM. Bipolar disorder in adults: choosing maintenance treatment. UpToDate website. https://www.uptodate.com/contents/ ...
Terms matched: 1  -  Score: 11  -  17 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_SSSB_June_2022.pdf
... will prevent rebate invoicing for both Fee-for-Service (FFS) and Managed Care Organization (MCO) 340B claims. The Medicaid Management Information System will be updated to accept ...
Terms matched: 1  -  Score: 52  -  09 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2801_20220609.pdf
... will prevent rebate invoicing for both Fee-for-Service (FFS) and Managed Care Organization (MCO) 340B claims. The Medicaid Management Information System will be updated to accept ...
Terms matched: 1  -  Score: 20  -  09 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2800_20220609.pdf
... 10, 2021, denied in error with error code 2017 (Recipient enrolled in MCO) . The impacted claims will be automatically reprocessed. A future remittance advice ...
Terms matched: 1  -  Score: 20  -  07 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2503_20210517.pdf
... . 14 3.14 Drugs Covered Under Fee-for-Service Medicaid for Recipients with Medicaid Managed Care (MCO Carve Out) .... 17 3.15 Medicare Part D Plan (PDP) ...
Terms matched: 1  -  Score: 39  -  07 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Pharmacy_Manual.pdf
... . 14 3.14 Drugs Covered Under Fee-for-Service Medicaid for Recipients with Medicaid Managed Care (MCO Carve Out) .... 17 3.15 Medicare Part D Plan (PDP) ...
Terms matched: 1  -  Score: 39  -  07 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT28_20220607.pdf
... . 14 3.14 Drugs Covered Under Fee-for-Service Medicaid for Recipients with Medicaid Managed Care (MCO Carve Out) .... 17 3.15 Medicare Part D Plan (PDP) ...
Terms matched: 1  -  Score: 39  -  07 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT28_20220310.pdf
... . 14 3.14 Drugs Covered Under Fee-for-Service Medicaid for Recipients with Medicaid Managed Care (MCO Carve Out) .... 17 3.15 Medicare Part D Plan (PDP) ...
Terms matched: 1  -  Score: 39  -  07 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT28_20220414.pdf
... Residential Habilitation Services) for recipients that were covered in a Managed Care Organization (MCO) adjudicated incorrectly. The following impacted claims have been reprocessed automatically. â ...
Terms matched: 1  -  Score: 21  -  07 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2797_20220607.pdf
... has had a rheumatology consultation, including the date of the visit: ____ Choose one of the following: The recipient has had RA for < six months ...
Terms matched: 1  -  Score: 21  -  06 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-157.pdf
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