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:
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    • 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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291. NV_BillingGuidelines_PT22_20181010.pdf
... claims for orthodontia must be submitted to the Nevada Medicaid fiscal agent, not the MCO. Please see the ADA Claim Form Instructions and the Orthodontic Medical Necessity ( ...
Terms matched: 1  -  Score: 20  -  09 Oct 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22_20181010.pdf
292. NV_BillingGuidelines_PT22_20170724.pdf
... emergency dental care only until the recipient is transitioned to a Managed Care Organization (MCO) at the beginning of their second full month of eligibility. ï ‚ ...
Terms matched: 1  -  Score: 88  -  10 Oct 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22_20170724.pdf
293. web_announcement_1714_20181018.pdf
... MMIS will occur in January 2019. Providers will have eight courses from which to choose to attend. Each four-hour training course will include details about the new system ...
Terms matched: 1  -  Score: 23  -  18 Oct 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_1714_20181018.pdf
294. Trading Partners Fully Certified Report.10.19.18.pdf
... / Dental Exchange X X Liberty Dental Plan (North) â€" (MCO) X Medical Transportation Management (MCO) X PNC Bank X Price Fass ...
Terms matched: 1  -  Score: 51  -  23 Oct 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Trading%20Partners%20Fully%20Certified%20Report.10.19.18.pdf
295. web_announcement_1768_20181206.pdf
... Provider Enrollment Requirement The 21st Century Cures Act requires all Medicaid Managed Care Organization (MCO) network providers to enroll with the Medicaid Program prior to enrolling with any ...
Terms matched: 1  -  Score: 131  -  06 Dec 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_1768_20181206.pdf
296. NV_BillingGuidelines_PT29_online_20170724.pdf
... by Managed Care Organizations (MCOs) . If a recipient is enrolled in an MCO, you must bill the MCO directly. If the recipient is enrolled in ...
Terms matched: 1  -  Score: 35  -  28 Dec 2018  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT29_online_20170724.pdf
297. NV_Billing_General_Modernization.pdf
... Prior Authorization requirements • New TPL contractor contact information • New MCO contact information 08/08/2008 Chapter 8 updated to reflect the mandatory ...
Terms matched: 1  -  Score: 292  -  17 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_Modernization.pdf
298. 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
299. PASRR_PWP_QRG.pdf
... to the PASRR application: 1) Click on your Admin tab. 2) Choose “Show Users for Name of Organizationâ€for Organization Profile. PASRR ...
Terms matched: 1  -  Score: 36  -  25 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/PASRR_PWP_QRG.pdf
300. NV_BillingGuidelines_PT10_20170724.pdf
... versus Fee For Service When a recipient is enrolled in a Managed Care Organization (MCO), request prior authorization from and submit claims to the MCO. When ...
Terms matched: 1  -  Score: 36  -  25 Jan 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT10_20170724.pdf
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