Nevada Medicaid and Nevada Check Up News (Fourth Quarter 2025 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

NOTIFICATION: Some Provider Flex services will be temporarily unavailable due to scheduled maintenance from 7 p.m. Pacific Time on Friday, March 6, 2026, to 11 a.m. Pacific Time on Saturday, March 7, 2026.

During this time:
  • New enrollment applications cannot be started.
  • Revalidation and Update applications will remain available; and
  • Previously started applications can still be accessed and resumed.

URGENT NOTIFICATION: Update regarding the Electronic Visit Verification (EVV) claims processing error. Nevada Medicaid did not receive some claims from Sandata (Optum) in time for the February 06, 2026 financial cycle. The issue was resolved this week. EVV providers can contact Sandata Technologies at (833) 545-0394 or support@sandata.com for assistance.

Known System Issues-Click HERE

Top 10 Claim Denial Reasons and Resolutions/Workarounds for January 2026 Professional Claims. See Web Announcement 3840.

Top Prior Authorization Denial Reasons for the Fourth Quarter of 2025. See Web Announcement 3830.

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.

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


Nevada Medicaid Now Offering Digital Health Information Access


For the first time, Nevadans enrolled in Medicaid can now download the new NVMedicaid app for instant access to their health information and Medicaid Card. The NVMedicaid App is only available to members 18 and over.The app has several features for recipients including:


  • View their health plan
  • Procedures
  • Contact information
  • Access resources
  • Review claims information
  • Search for providers
  • Receive broadcast messages

The app also allows recipients to receive messages from NV Medicaid and quickly find providers in their network.


NVMedicaid is a web based application and can be accessed online at https://mdp.medicaid.nv.gov/


The State developed the app in partnership with contractor Gainwell Technologies. The app, called “NVMedicaid” is available on the Apple App Store, and Google Play. People enrolled in Medicaid can access their claims information and Medicaid card, meaning there is no need to carry a physical card anymore.


Health data is federally protected, so Medicaid recipients must sign up for data-sharing. For more information, please visit: https://dhcfp.nv.gov/Resources/MDPResource/

Nevada Medicaid Recipient Resources:

Access the NVMedicaid Application Provider Guide for detailed information on how to download and use the NVMedicaid App.


Visit https://dhcfp.nv.gov/Resources/MDPResource/ for more information about accessing health information through apps.


For more info: English NV Medicaid App

For more info: Spanish NV Medicaid App


Nevada Medicaid and the Division of Welfare and Supportive Services have an easy way for members to update their address. Simply follow the link to complete the form https://dhcfp.nv.gov/UpdateMyAddress/