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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Top 10 Claim Denial Reasons and Resolutions/Workarounds for February 2026 Professional Claims. See Web Announcement 3863.

Top Prior Authorization Denial Reasons for the Fourth Quarter of 2025. See Web Announcement 3830.

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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281. web_announcement_1629_20180628.pdf
... 834 Benefit Enrollment and Maintenance, which are used by the Managed Care Organization (MCO) Trading Partners. (Outbound files are those sent from Nevada Medicaid to ...
Terms matched: 1  -  Score: 21  -  29 Jun 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_1629_20180628.pdf
282. NV_EDI_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  -  06 Aug 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_EDI_Trading%20Partner%20User%20Guide.pdf
283. NV_BillingGuidelines_PT43_20180829.pdf
... EPSDT) program. Managed Care For recipients enrolled in a Managed Care Organization (MCO), it is the laboratory’s responsibility to comply with all ...
Terms matched: 1  -  Score: 41  -  29 Aug 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT43_20180829.pdf
284. NV_BillingGuidelines_PT43_20170322.pdf
... the EPSDT program. Managed care For recipients enrolled in a Managed Care Organization (MCO), it is the laboratory’s responsibility to comply with all ...
Terms matched: 1  -  Score: 41  -  29 Aug 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT43_20170322.pdf
285. NV_Billing_General_20180108.pdf
... ï ‚ Prior Authorization requirements ï ‚ New TPL contractor contact information ï ‚ New MCO contact information 08/08/2008 Chapter 8 updated to reflect the mandatory ...
Terms matched: 1  -  Score: 284  -  10 Sep 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20180108.pdf
286. NV_Billing_General_20180201.pdf
... ï ‚ Prior Authorization requirements ï ‚ New TPL contractor contact information ï ‚ New MCO contact information 08/08/2008 Chapter 8 updated to reflect the mandatory ...
Terms matched: 1  -  Score: 284  -  10 Sep 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20180201.pdf
287. NV_Billing_General_20170901.pdf
... ï ‚ Prior Authorization requirements ï ‚ New TPL contractor contact information ï ‚ New MCO contact information 08/08/2008 Chapter 8 updated to reflect the mandatory ...
Terms matched: 1  -  Score: 284  -  10 Sep 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20170901.pdf
288. Provider_Enrollment_and_Program_Integrity_Conference_Presentation.pdf
... Service Medicaid o Ensures all applicable ACA screenings are completed prior to enrolling in an MCO network o Network providers are not required to see FFS recipients 12 Division of ...
Terms matched: 1  -  Score: 20  -  21 Sep 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_and_Program_Integrity_Conference_Presentation.pdf
289. Multiple_Sclerosis_Agents_2018-11.pdf
... and published resources when making medical decisions. â — ‹ For active RRMS, choosing among the wide range of available drugs from the modestly effective to the highly ...
Terms matched: 1  -  Score: 23  -  09 Oct 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Multiple_Sclerosis_Agents_2018-11.pdf
290. Opioid_Use_Disorder_Agents_2018-11.pdf
... Opioid Treatment Program. In addition, DATA reduced the regulatory burden on physicians who choose to practice opioid addiction therapy by permitting qualified physicians to apply for and receive ...
Terms matched: 1  -  Score: 16  -  09 Oct 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Opioid_Use_Disorder_Agents_2018-11.pdf
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