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 July 2026 Professional Claims. See Web Announcement 3983.

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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... 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: 47  -  18 Nov 2025  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT43_20250804.pdf
... methodology for approved services provided by FQHC qualified health professionals. Managed Care Organizations (MCO) are required to follow Nevada Medicaid’s State Plan and Medicaid ...
Terms matched: 1  -  Score: 47  -  06 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT17_Specialty_181_20260102.pdf
... : • Answer the Challenge Question to verify identity. • Choose whether log in is on a personal computer or public computer. †...
Terms matched: 1  -  Score: 46  -  27 Oct 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Therapy_Provider_Training_093020.pdf
... Daily files will be generated if DHCFP has updates for a recipient enrolled in an MCO. If no updates are performed, then no enrollment file will be generated ...
Terms matched: 1  -  Score: 46  -  28 Sep 2024  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Benefit_Enrollment_and_Maintenance_(834)_-_Mod.pdf
... , Thrombolytic antithrombotic therapy is not recommended. For patients who th Therapy 9 Edition choose antithrombotic therapy, aspirin (75 to 325 mg daily) is 9 ( ...
Terms matched: 1  -  Score: 46  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Platelet%20Inhibitors_07262012.pdf
... ), Thrombolytic antithrombotic therapy is not recommended. For patients who Therapy 9th Edition choose antithrombotic therapy, aspirin (75 to 325 mg daily) is (2012 ...
Terms matched: 1  -  Score: 46  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Platelet%20Inhibitors.pdf
... risk of stroke: no therapy is suggested over antithrombotic therapy. For patients who choose antithrombotic therapy, aspirin is suggested over oral anticoagulation or combination therapy with aspirin ...
Terms matched: 1  -  Score: 45  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Oral%20Anticoagulants_03192013.pdf
... risk of stroke: no therapy is suggested over antithrombotic therapy. For patients who choose antithrombotic therapy, aspirin is suggested over oral anticoagulation or combination therapy with aspirin ...
Terms matched: 1  -  Score: 45  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Oral_Anticoagulants_2014-0918.pdf
... risk of stroke: no therapy is suggested over antithrombotic therapy. For patients who choose antithrombotic therapy, aspirin is suggested over oral anticoagulation or combination therapy with aspirin ...
Terms matched: 1  -  Score: 45  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Oral_Anticoagulants_2013-0812.pdf
... risk of stroke: no therapy is suggested over antithrombotic therapy. For patients who choose antithrombotic therapy, aspirin is suggested over oral anticoagulation or combination therapy with aspirin ...
Terms matched: 1  -  Score: 45  -  15 Jun 2017  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Oral%20Anticoagulants_092212.pdf
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