Nevada Medicaid and Nevada Check Up News (First Quarter 2019 Provider Newsletter) [Read]

Behavioral Health Providers Invited to Attend Monthly DHCFP Webinars [See Web Announcement 1628]

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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Known Modernization System Issues-Click HERE

Paper claims are no longer accepted by Nevada Medicaid. Please refer to Web Announcement 1733 and Web Announcement 1829 for additional information.

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 dhcfp.nv.gov and the Billing Guide for your provider type at www.medicaid.nv.gov.

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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

Provider Enrollment Checklists

To see which documents must be submitted with your Provider Enrollment Packet, click the name of your provider type(s) in the list below. If your provider type is not in the list below, please contact the Provider Enrollment Unit at (877) 638-3472 for requirements.

Note: Out of state providers must also submit proof of Medicaid eligibility in the state that services are/were rendered.

Provider Type Title Updated Date
10 Outpatient Surgery, Hospital Based 04/20/16
11 Hospital, Inpatient 02/18/16
12 Hospital, Outpatient 02/18/16
13 Psychiatric Hospital, Inpatient 04/20/16
14 Behavioral Health Outpatient Treatment n/a
15 Registered Dietitian 12/15/17
16 Intermediate Care Facilities for Individuals with Intellectual Disabilities, Public 04/20/16
17 Special Clinics n/a
19 Nursing Facility 04/20/16
20 Physician, M.D., Osteopath, D.O. 08/25/17
21 Podiatrist 08/25/17
22 Dentist 01/03/13
23 Hearing Aid Dispenser & Related Supplies 08/25/17
24 Advanced Practice Registered Nurse 08/30/17
25 Optometrist 08/25/17
26 Psychologist 07/19/16
27 Radiology and Non-invasive Diagnostic Centers 12/01/14
28 Pharmacy 04/28/17
29 Home Health Agency 07/05/17
30 Personal Care Services - Provider Agency 10/04/16
32 Ambulance, Air or Ground 10/25/17
33 Durable Medical Equipment, Prosthetics, Orthotics and Disposable Medical Supplies (DMEPOS) 07/05/17
34 Therapy n/a
36 Chiropractor 08/30/17
38 Home & Community Based Waiver – Individuals with Intellectual Disabilities and Related Conditions n/a
39 Adult Day Health Center 03/10/15
41 Optician, Optical Business, Ocularist 12/07/12
43 Laboratory, Pathology Clinical 08/30/17
44 Swing-bed, Acute Hospital 04/20/16
45 End Stage Renal Disease (ESRD) Facility 08/30/17
46 Ambulatory Surgical Centers, Freestanding 08/30/17
47 Indian Health Programs and Tribal Clinics 12/17/12
48 Home and Community Based Services Waiver for the Frail Elderly n/a
51 Indian Health Service Hospital, Inpatient (Tribal) 04/24/15
52 Indian Health Service Hospital, Outpatient (Tribal) 08/30/17
54 Targeted Case Management 05/17/19
55 Transitional Rehabilitative Center, Outpatient 11/30/12
56 Inpatient Rehabilitation and Long Term Acute Care (LTAC) Specialty Hospitals 02/19/16
57 Home and Community Based Services Waiver for the Elderly in Adult Residential Care 12/29/16
58 Waiver for Persons with Physical Disabilities (“PD”) n/a
59 Home and Community Based Services Waiver for the Elderly – Augmented Personal Care Services 12/29/16
60 School Based 08/30/17
63 Residential Treatment Center (RTC) 08/13/14
64 Hospice 04/20/16
65 Hospice, Long Term Care 04/20/16
68 Intermediate Care Facilities for Individuals with Intellectual Disabilities, Private 04/20/16
72 Nurse Anesthetist 08/30/17
74 Nurse Midwife 08/30/17
75 Critical Access Hospital (CAH), Inpatient 02/18/16
76 Audiologist n/a
77 Physician's Assistant 08/30/17
78 Indian Health Service Hospital, Inpatient (Non-Tribal) 08/30/17
79 Indian Health Service Hospital, Outpatient (Non-Tribal) 08/30/17
81 Hospital Based End Stage Renal Disease (ESRD) Provider 10/02/15
82 Behavioral Health Rehabilitative Treatment n/a
83 Personal Care Services - Intermediary Service Organization 10/04/16
85 Applied Behavior Analysis (ABA) n/a

If you have any questions, please contact the Provider Enrollment Unit at (877) 638-3472 from 8:00AM to 5:00PM, Monday through Friday.