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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    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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411. Multiple_Sclerosis_Agents_2020-12.pdf
... within 6 months of discontinuation (Level A) . Physicians and people with MS choosing to switch from natalizumab to ï ngolimod should initiate treatment within 8 to 12 ...
Terms matched: 1  -  Score: 23  -  26 Oct 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Multiple_Sclerosis_Agents_2020-12.pdf
412. Anticonvulsants_2020-12.pdf
... ; November 2017. • Post RM. Bipolar disorder in adults: choosing maintenance treatment. UpToDate website. www.uptodate.com. Updated November 9, 2019. ...
Terms matched: 1  -  Score: 10  -  26 Oct 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Anticonvulsants_2020-12.pdf
413. Anthem_DUR_Binder_Oct_2020.pdf
... Presentation Presented to NV DUR Board on October 22, 2020 DRUG USE REVIEW BOARD MCO PRIOR AUTHORIZATION CRITERIA REVIEW FORM Clinical criteria for drugs or drug classes listed on ...
Terms matched: 1  -  Score: 63  -  25 Sep 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Anthem_DUR_Binder_Oct_2020.pdf
414. SilverSummit_DUR_Binder_Oct_2020.pdf
... - 24 Standard DUR Reports - 26 Topical Antipruritics Clinical Presentation DRUG USE REVIEW BOARD MCO PRIOR AUTHORIZATION CRITERIA REVIEW FORM Clinical criteria for drugs or drug classes listed on ...
Terms matched: 1  -  Score: 60  -  25 Sep 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/SilverSummit_DUR_Binder_Oct_2020.pdf
415. Health_Plan_of_Nevada_DUR_Binder_Oct_2020.pdf
... Drug Use Review Board Meeting OCTOBER 22, 2020 2020 3 DRUG USE REVIEW BOARD MCO PRIOR AUTHORIZATION CRITERIA REVIEW FORM Clinical criteria for drugs or drug classes listed on ...
Terms matched: 1  -  Score: 60  -  25 Sep 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Health_Plan_of_Nevada_DUR_Binder_Oct_2020.pdf
416. FFS_DUR_Binder_Oct_2020.pdf
... ) . Physicians and people with MS choosing to switch from natalizumab to ï ngolimod ... CMS. The Fee-for- Service and MCO Surveys will be presented at the next ...
Terms matched: 2  -  Score: 31  -  25 Sep 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FFS_DUR_Binder_Oct_2020.pdf
417. FFS_DUR_Survey_FFY2019.pdf
... , program oversight of managed care partners when applicable, and statewide (FFS and MCO) initiatives. The Drug Use Review Board (DUR) is a requirement ...
Terms matched: 1  -  Score: 12  -  25 Sep 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FFS_DUR_Survey_FFY2019.pdf
418. Multiple_Sclerosis_Agents_2020-09.pdf
... within 6 months of discontinuation (Level A) . Physicians and people with MS choosing to switch from natalizumab to ï ngolimod should initiate treatment within 8 to 12 ...
Terms matched: 1  -  Score: 23  -  03 Sep 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Multiple_Sclerosis_Agents_2020-09.pdf
419. E-Binder_SSSB_Sept_2020.pdf
... within 6 months of discontinuation (Level A) . Physicians and people with MS choosing to switch from natalizumab to ï ngolimod should initiate treatment within 8 to 12 ...
Terms matched: 1  -  Score: 66  -  17 Aug 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_SSSB_Sept_2020.pdf
420. Provider_Relief_Fund_Step-by-Step_Provider_Guide.pdf
... – ª Self directed providers disabilities) $175 billion â – ª Providers that choose to accept funds must attest to the terms and conditions in payments to be ...
Terms matched: 1  -  Score: 41  -  14 Aug 2020  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Relief_Fund_Step-by-Step_Provider_Guide.pdf
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