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 June 2026 Professional Claims. See Web Announcement 3964.

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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... 1 /2019 6/25/2019 Managed Care, Managed Care Organization (MCO), all details on NDC (National outpatient or outpatient cross-over claims are ...
Terms matched: 1  -  Score: 40  -  06 Apr 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Modernization%20System_Known%20Issues.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  -  02 May 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Trading_Partners_Fully_Certified_Report.pdf
... submitted in writing. You may submit comments in one of two ways (please choose only one of the ways listed): Electronically: You may email comments ...
Terms matched: 1  -  Score: 16  -  10 May 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2781_20220510.pdf
... systems are not required for the providers to respond to the data request if they choose to do so. A small number of respondents expressed privacy concerns regarding information ...
Terms matched: 1  -  Score: 12  -  12 May 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2782_20220512.pdf
... 2020 35 Available transactions Trading Partners can choose to enroll for the following HIPAA Standard ... contractor contact information • New MCO contact information 08/08/2008 ...
Terms matched: 2  -  Score: 192  -  23 May 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_Billing_General_20201117.pdf
... has had a rheumatology consultation, including the date of the visit: ____ Choose one of the following: The recipient has had RA for < six months ...
Terms matched: 1  -  Score: 21  -  06 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/FA-157.pdf
... Residential Habilitation Services) for recipients that were covered in a Managed Care Organization (MCO) adjudicated incorrectly. The following impacted claims have been reprocessed automatically. â ...
Terms matched: 1  -  Score: 21  -  07 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2797_20220607.pdf
... . 14 3.14 Drugs Covered Under Fee-for-Service Medicaid for Recipients with Medicaid Managed Care (MCO Carve Out) .... 17 3.15 Medicare Part D Plan (PDP) ...
Terms matched: 1  -  Score: 39  -  07 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT28_20220310.pdf
... . 14 3.14 Drugs Covered Under Fee-for-Service Medicaid for Recipients with Medicaid Managed Care (MCO Carve Out) .... 17 3.15 Medicare Part D Plan (PDP) ...
Terms matched: 1  -  Score: 39  -  07 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT28_20220414.pdf
... . 14 3.14 Drugs Covered Under Fee-for-Service Medicaid for Recipients with Medicaid Managed Care (MCO Carve Out) .... 17 3.15 Medicare Part D Plan (PDP) ...
Terms matched: 1  -  Score: 39  -  07 Jun 2022  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT28_20220607.pdf
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