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]

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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.

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501. E-Binder_PT_June_2019.pdf
... combining all of them together would be more confusing and would then lead to not choosing the simplest which would be the oral form or if they advocate that it ...
Terms matched: 1  -  Score: 65  -  16 May 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/E-Binder_PT_June_2019.pdf
502. Antidepressants_SSRI_2019-06.pdf
... of PTSD (VA/DoD 2017) â — ‹ For those patients who choose not to engage in or are unable to access trauma-focused psychotherapy, the use ...
Terms matched: 1  -  Score: 24  -  14 May 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Antidepressants_SSRI_2019-06.pdf
503. Multiple_Sclerosis_Agents_2019-06.pdf
... lesions assessed at least annually) . (Strong) o For active RRMS, choosing among the wide range of available drugs from the modestly effective to the highly ...
Terms matched: 1  -  Score: 23  -  14 May 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Multiple_Sclerosis_Agents_2019-06.pdf
504. Anticonvulsants_2019-06.pdf
... Pharmaceuticals; November 2017. ï ‚ Post RM. Bipolar disorder in adults: choosing maintenance treatment. UpToDate Web site. www.uptodate.com. Updated November 2, 2017 ...
Terms matched: 1  -  Score: 10  -  14 May 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Anticonvulsants_2019-06.pdf
505. NV_BillingGuidelines_PT63_20170724.pdf
... FFS) Medicaid. If the recipient is enrolled in a Managed Care Organization (MCO), the MCO is responsible for reimbursement of the first month of admission ...
Terms matched: 1  -  Score: 108  -  29 Apr 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT63_20170724.pdf
506. Therapy_Provider_Training_042619.pdf
... : • Answer the Challenge Question to verify identity. • Choose whether log in is on a personal computer or public computer. †...
Terms matched: 1  -  Score: 111  -  26 Apr 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Therapy_Provider_Training_042619.pdf
507. Dental_and_Orthodontia_Training_042419.pdf
... Type in their answer to the Challenge 4 Question to verify identity 5 4. Choose whether log in is on a personal computer or public computer 5. Click ...
Terms matched: 1  -  Score: 68  -  24 Apr 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Dental_and_Orthodontia_Training_042419.pdf
508. ABA_Provider_Training_041219.pdf
... continued • While on the “Formsâ€page, locate and choose appropriate forms • Make sure that all instructions are followed †...
Terms matched: 1  -  Score: 97  -  12 Apr 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/ABA_Provider_Training_041219.pdf
509. NV_BillingGuidelines_PT22_20190201.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  -  10 Apr 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22_20190201.pdf
510. NV_BillingGuidelines_PT29_online_20190201.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  -  05 Apr 2019  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT29_online_20190201.pdf
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