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:
  • All secure Provider Web Portal (PWP) functions
  • Provider Flex
  • Gabby®, which includes:
    • Gainwell Technologies Contact Center (877) 638-3472
    • Automated Response System (ARS) (800) 942-6511
  • Real time CAQH/CORE EDI eligibility and claim verification
  • Provider Pre-Admission Screening Resident Review (PASRR)
    • Known System Issues-Click HERE

    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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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.

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271. NV_EnrollmentChecklist_PT82_Spec300.pdf
... acknowledge in writing that they understand their right to select a qualified provider of their choosing; and 7. Only qualified providers provide prescribed services within scope of their ...
Terms matched: 1  -  Score: 20  -  28 Jul 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EnrollmentChecklist_PT82_Spec300.pdf
272. NV_EnrollmentChecklist_PT14_Spec300.pdf
... acknowledge in writing that they understand their right to select a qualified provider of their choosing; and 7. Only qualified providers provide prescribed services within scope of their ...
Terms matched: 1  -  Score: 20  -  28 Jul 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EnrollmentChecklist_PT14_Spec300.pdf
273. web_announcement_2834_20220706.pdf
... the enrollees to have sufficient time to choose an MCO and return their letter to ... Nevada Check Up Managed Care Organization (MCO) 2022 Open Enrollment Managed Care Organization ...
Terms matched: 2  -  Score: 154  -  06 Jul 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2834_20220706.pdf
274. web_announcement_2826_20220701.pdf
... will prevent rebate invoicing for both Fee-for-Service (FFS) and Managed Care Organization (MCO) 340B claims. The Medicaid Management Information System has been updated to accept ...
Terms matched: 1  -  Score: 52  -  01 Jul 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2826_20220701.pdf
275. web_announcement_2825_20220701.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  -  01 Jul 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2825_20220701.pdf
276. E-Binder_SSSB_June_2022.pdf
... ; 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
277. 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: 52  -  09 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2801_20220609.pdf
278. web_announcement_2800_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
279. web_announcement_2503_20210517.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
280. 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_Pharmacy_Manual.pdf
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