Nevada Medicaid and Nevada Check Up News (Second Quarter 2023 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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Top 10 Claim Denial Reasons and Resolutions/Workarounds for August 2023 Professional Claims. See Web Announcement 3164.

Top Prior Authorization Denial Reasons for the Second Quarter of 2023. See Web Announcement 3138.

Top 10 Enrollment Return Reasons and Resolutions for First Quarter 2021 Submissions. See Web Announcement 2501.

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DateAnnouncement NumberTopic
Sep 27, 20233175Attention Provider Type 19 (Nursing Facility): Clarification of Managed Care Organization Responsibility for the First 180 Days of Nursing Facility Level of Care
Sep 27, 20233174The Bivalent Moderna and Pfizer-BioNTech COVID-19 Vaccines Are Excluded From Coverage
Sep 26, 20233173Attention All Providers, Delegates and Staff: Upcoming Training Sessions for October 2023
Sep 26, 20233172Error Codes 5635, 5636, 5637 and 5654 No Longer Apply to Crossover Claim Types
Sep 21, 20233171Attention Provider Type 86 (Specialized Foster Care): Modifier U8 Is No Longer Required on Initial Claims
Sep 21, 20233170Other Health Coverage (OHC) Non-covered Services Billing Instructions
Sep 20, 20233169New Error Code Based on Ordering, Providing and Referring (OPR) Provider’s Nevada Medicaid Enrollment
Sep 20, 20233168Error Codes 5613 and 5634 No Longer Apply to Crossover Claim Types
Sep 19, 20233167Attention Provider Types 19 (Nursing Facility) and 65 (Hospice, Long Term Care): State Fiscal Year 2024 Quarter 1 Rate Updates Implemented
Sep 18, 20233166Medicaid Services Manual Chapters and Medicaid Operations Manual Chapters Updated
Sep 15, 20233165URGENT Announcement for All Providers: Medicaid Member Reinstatement
Sep 15, 20233164Attention All Providers: Top 10 Claim Denial Reasons and Resolutions/Workarounds for August 2023 Professional Claims
Sep 14, 20233163Reminder: Deadline for Current Rate Review Surveys for Certain Provider Types and Services Is September 29, 2023
Sep 13, 20233162Claims for COVID-19 Vaccine Administration Codes Have Been Reprocessed
Sep 13, 20233161Error Codes 5594, 5597 and 5611 No Longer Apply to Crossover Claim Types
Sep 11, 20233160Attention Provider Type 38 (Home and Community Based Services Waiver for Individuals with Intellectual and Developmental Disabilities): Rate Updates Implemented
Sep 07, 20233159Error Code 5592 No Longer Applies to Crossover Claim Types
Sep 05, 202331582023 Annual New Code Update: Claims for Some Procedure Codes Have Been Reprocessed
Sep 01, 20233157Attention Provider Type 54 (Targeted Case Management) Providers: Medicaid Services Manual Chapter 2500 and State Plan Supplement 1 to Attachment 3.1-A Updated
Sep 01, 20233156Annual Rate Adjustment for Provider Type 17 (Special Clinics), Specialty 180 (Rural Health Clinics)
Aug 30, 20233155Error Codes 5649 and 6507 No Longer Apply to Crossover Claim Types
Aug 29, 20233154COVID-19 UNWIND: Emergency Use Authorization Revoked for Monoclonal Antibody and Injection Procedure Codes
Aug 28, 20233153Attention Provider Type 22 (Dentist): Every Smile Matters Nevada Project Includes Workshop and Survey
Aug 28, 20233152Attention Provider Type 22 (Dentist): Claims for Prophylaxis, Crown, Gingivectomy and Alveoloplasty Reprocessed
Aug 25, 20233151Attention All Providers: Top 10 Claim Denial Reasons and Resolutions/Workarounds for July 2023 Professional Claims
Aug 24, 20233150Attention Behavioral Health Providers: Procedure Code H2017 Limitations
Aug 23, 20233149Attention Provider Type 22 (Dentist): Claims for Some Dental Procedure Codes Reprocessed
Aug 22, 20233148Attention All Providers: Sign Up for Electronic 1099s
Aug 22, 20233147Treatment History Search Function Expanded to Include Behavioral Health Provider Types
Aug 21, 20233146Attention Provider Types 60 (School Health Services) and 85 (Applied Behavior Analysis (ABA)): Update on ABA Procedure Codes 97154, 97157, 97158
Aug 15, 20233145Attention Provider Types 19 (Nursing Facility) and 65 (Hospice, Long Term Care): Duplicate Inpatient Hospice Claims Reprocessed
Aug 10, 20233144Attention All Providers: Invitation to Participate in Focus Groups Regarding Services for Nevada’s Aged, Blind and Disabled
Aug 10, 20233143Claims Denied With Error Codes 4221 or 4223
Aug 09, 20233142Attention Provider Types 20 (Physician, M.D., Osteopath, D.O.) and 24 (Advanced Practice Registered Nurses): Claims for Procedure Codes G0433 and G0443 Reprocessed
Aug 07, 20233141Attention Provider Type 63 (Residential Treatment Center): Reminder to Submit Claims to Managed Care Organizations
Aug 04, 20233140Attention Provider Type 19 (Nursing Facility): Submission of Nursing Facility Tracking Requests for DISCHARGES
Aug 04, 20233139Attention All Providers, Delegates and Staff: Upcoming Training Sessions for September 2023
Aug 03, 20233138Attention All Providers: Top Prior Authorization Denial Reasons for the Second Quarter of 2023
Aug 01, 20233137Attention Provider Type 17 (Special Clinics) Specialty 166 (Family Planning): Update Regarding Procedure Code 99070 (Supplies and Materials Provided by Physician)
Aug 01, 20233136Service Limitation for Mammography Procedure Codes 77063 and 77067 Is Once Per Year Per Recipient
Aug 01, 20233135Attention Provider Type 38 (Home and Community Based Services Waiver for Individuals with Intellectual and Developmental Disabilities): Claims for Procedure Code S5190 Rendered by Specialty 215 (Counseling Service)
Jul 31, 20233134Rate Review Surveys for Certain Provider Types and Services
Jul 26, 20233133The Monovalent Moderna and Pfizer-BioNTech COVID-19 Vaccines Are Excluded From Coverage
Jul 26, 20233132Medicaid Services Manual Chapters Updated
Jul 24, 20233131Attention Provider Type 13 (Psychiatric Hospital, Inpatient): 1115 Institution for Mental Disease (IMD) Substance Use Disorder (SUD) Demonstration Waiver
Jul 24, 20233130Attention All Providers, Delegates and Staff: Upcoming Training Sessions for August 2023
Jul 21, 20233129Electronic Funds Transfer Requirements for Individuals Linking to a Group
Jul 21, 20233128Attention Provider Type 12 (Hospital, Outpatient): Error Code 5515 Updated to Apply to Procedure Codes 84484 and 92516
Jul 21, 20233127COVID-19 UNWIND: COVID-19 General Billing Guide Updated
Jul 20, 20233126Attention All Providers: Top 10 Claim Denial Reasons and Resolutions/Workarounds for June 2023 Professional Claims
Jul 19, 20233125Attention Provider Types 28 (Pharmacy) and 91 (Pharmacist): Pharmacists Can Now Bill Medicaid and Provide New Services
Jul 18, 20233124COVID-19 UNWIND: Attention Qualified Mental Health Associate (QMHA) and Qualified Behavioral Aide (QBA) Applicants: Clarification on Enrollment Requirements for Cardiopulmonary Resuscitation (CPR) Certification for Initial Competency Training
Jul 18, 20233123Medicaid Management Information System Updated with NCCI Quarter 3 2023 Files
Jul 14, 20233122Billing Reminder Regarding Specialty Physician Administered Drugs
Jul 14, 20233121Attention All Providers, Delegates, Staff, Credentialing Companies and Third-Party Billers: Feedback Requested Regarding the Gabby™ Interactive Voice Response (IVR) System
Jul 13, 20233120Error Code 5068 Updated for Crossover Claim Types
Jul 12, 20233119Urgent Updates Regarding Electronic Visit Verification (EVV) Providers and System Vendor
Jul 11, 2023Volume 20 Issue 2COVID-19 UNWIND: Nevada Medicaid and Nevada Check Up News (Second Quarter 2023 Provider Newsletter)
Jul 11, 20233118COVID-19 UNWIND: Reminder to Use Procedure Codes G0314 and G0315 for COVID-19 or Early and Periodic Screening, Diagnosis & Treatment Vaccine Counseling
Jul 10, 20233117Attention Provider Types 63 (Residential Treatment Centers) and 68 (Intermediate Care Facilities for Individuals with Intellectual Disabilities/Private): Inpatient Claims Denied with Error Code 3009 Have Been Reprocessed
Jul 10, 20233116Attention Provider Types 64 (Hospice) and 65 (Hospice, Long Term Care): Claims Denied With Error Code 5029 Have Been Reprocessed
Jul 07, 20233115Public Workshop Scheduled July 17, 2023, Regarding Needs Assessment for Nevada’s Aged, Blind and Disabled (ABD) Population
Jul 07, 20233114Attention Provider Type 63 (Residential Treatment Center (RTC)/Psychiatric Residential Treatment Facility (PRTF)): Reminder Regarding Therapeutic Home Pass Policy Requirements
Jul 06, 20233113Silver State Scripts Board (SSSB) Made Changes to Preferred Drug List (PDL) Effective July 6, 2023
Jul 06, 20233112Attention Provider Types 20 (Physician, M.D., Osteopath, D.O.), 24 (Advanced Practice Registered Nurse), 74 (Nurse Midwife) and 77 (Physician Assistant): Removal of DEA X-Waiver for Prescribing Buprenorphine
Jul 06, 20233111Error Code 5589 No Longer Applies to Crossover Claim Types
Jul 03, 20233110COVID-19 UNWIND: COVID-19 Services for Uninsured Individuals
Jul 03, 20233109Drug Use Review (DUR) Board Approves Changes Effective July 3, 2023
Jun 30, 20233108Drug Use Review (DUR) Board Approves Changes for Physician Administered Drugs (PAD)
Jun 30, 20233107Medicaid Services Manual Chapters Updated
Jun 29, 20233106COVID-19 UNWIND: How Hospitals Can Help Patients Who Are Disenrolled from Medicaid
Jun 29, 20233105Attention Provider Type 33 (Durable Medical Equipment, Prosthetics, Orthotics and Supplies): Error Codes 5581 and 5596 Updated
Jun 28, 20233104COVID-19 Vaccine Incentive Fee Increase Effective January 1, 2023
Jun 27, 20233103Nevada Medicaid and Nevada Check Up Managed Care Organization (MCO) 2023 Open Enrollment
Jun 27, 20233102Attention All Providers: Top 10 Claim Denial Reasons and Resolutions/Workarounds for May 2023 Professional Claims
Jun 23, 20233101Attention All Providers, Delegates and Staff: Upcoming Training Sessions for July 2023
Jun 23, 20233100Provider Type 55 (Day and Residential Habilitation Services) Separated into Two Specialties: Specialty 315 for Day Habilitation and Specialty 316 for Residential Habilitation
Jun 22, 20233099Attention Provider Type 48 (Home and Community Based Waiver for the Frail Elderly): Day Care Services Procedure Codes S5100 and S5102 Cannot Be Billed With Same Date of Service
Jun 21, 20233098Inpatient Claim Denials for Revenue Code on Prior Authorization Not Matching Revenue Code on the Claim
Jun 20, 20233097Attention All Providers: Guidance Regarding Group and Individual Provider Enrollment
Jun 20, 20233096Availability of the “Revalidate Provider” Link to Start Revalidation Application
Jun 20, 20233095Attention Provider Type 60 (School Health Services): Speech Pathology and Vision Procedure Codes Not Payable
Jun 20, 20233094Attention Inpatient Hospitals: Claims for Newborn Admission Revenue Codes 170, 171 and 172 That Denied Have Been Reprocessed
Jun 12, 20233093Professional Crossover Claims to Deny Correctly With Error Code 1008
Jun 08, 20233092Error Codes 5564, 5586, 5600 and 5626 Updated for Crossover Claim Types
Jun 06, 20233091Attention Dental Medicaid Service Providers, Schools, Health Centers and Clinics: Funding Available for Delivery of Dental Sealants and Fluoride Varnish
Jun 06, 20233090Expansion of Medicaid Coverage to Lawfully Residing Non-Citizen Pregnant Individuals
Jun 06, 20233089Attention Provider Types (PTs) 45 (End Stage Renal Disease (ESRD) Facility) and 81 (Hospital Based ESRD Provider): Outpatient Crossover Claims Submitted in 2021 for Dialysis Codes 90945 and 90999 Reprocessed
Jun 06, 20233088Hysterectomy Procedure Codes Opened for Outpatient Surgery Provider Types
Jun 02, 20233087Urgent Announcement Regarding Claims Suspending for Budget Relief
Jun 02, 20233086COVID-19 UNWIND: COVID-19 General Billing Guide Updated
Jun 01, 20233085Providers May Update Demographic Information Using Electronic Verification System (EVS) Starting June 20, 2023
Jun 01, 20233084Attention Provider Type 60 (School Health Services): Modifiers Will Be Required When Billing Applied Behavior Analysis Services Procedure Codes
May 25, 20233083Attention All Providers, Delegates and Staff: Upcoming Training Sessions for June 2023
May 22, 202330822023 Annual New Code Update: Rates Have Been Entered and Suspended Claims Have Been Released
May 22, 20233081Attention All Providers: Information Regarding Claims Denying for Medicare Coinsurance Greater Than Medicare Paid Amount
May 19, 20233080Attention All Providers, Delegates, Staff, Credentialing Companies and Third-Party Billers: New Call Center Interactive Voice Response System Now Answering Providers Questions
May 19, 20233079Error Code 5054 Updated for Crossover Claim Types
May 18, 20233078Attention All Providers: Top 10 Claim Denial Reasons and Resolutions/Workarounds for April 2023 Professional Claims
May 16, 20233077Attention Freestanding Birthing Centers and Professional Practitioners Billing Procedure Code 59409 (Vaginal Delivery) (Updated September 18, 2023)
May 16, 20233076Attention All Providers: New Process to Identify Recipients Participating in a Clinical Trial
May 15, 20233075Indian Health Program Rates Adjusted for Calendar Year 2023
May 15, 20233074Attention All Providers: Top Prior Authorization Denial Reasons for the First Quarter of 2023
May 11, 20233073Attention Home and Community Based Services (HCBS) Providers: Rate Survey Opens and Survey Training Sessions Scheduled
May 11, 20233072COVID-19 UNWIND: End of the COVID-19 Public Health Emergency Impacts Provider Enrollment Flexibilities
May 10, 20233071Attention Provider Type 60 (School Health Services): Modifiers Will Be Required When Billing Applied Behavior Analysis Services Procedure Codes
May 09, 20233070COVID-19 UNWIND: Two Services No Longer Permitted Using Telehealth Effective May 12, 2023
May 08, 20233069Attention Provider Types 19 (Nursing Facility) and 65 (Hospice, Long Term Care): State Fiscal Year 2023 Quarter 4 Rate Updates Implemented
May 05, 20233068COVID-19 UNWIND: Authorization for Monovalent COVID-19 Vaccine Procedure Codes Revoked (Updated August 11, 2023)
May 04, 20233067COVID-19 UNWIND: COVID-19 Prior Authorization Requirements Changing
May 02, 20233066COVID-19 UNWIND: COVID-19 Billing Guide Updated
May 01, 20233065Attention Provider Type 25 (Optometrist): Procedure Code 76514 Open for Billing
May 01, 20233064Drug Use Review (DUR) Board Approves Changes Effective May 1, 2023
May 01, 20233063Institutional Claims With Type of Bill Ending in 8
Apr 28, 20233062Changes Made to Diabetic Supplies Preferred Product List Effective April 27, 2023
Apr 27, 20233061Claims Denied with Error Code 5005 Have Been Reprocessed
Apr 27, 20233060Attention All Providers, Delegates, Staff, Credentialing Companies and Third-Party Billers: New Call Center Interactive Voice Response System Is Now Live
Apr 27, 20233059Silver State Scripts Board (SSSB) Made Changes to Preferred Drug List (PDL) Effective April 27, 2023
Apr 25, 20233058Error Code 5051 Updated for Crossover Claim Types
Apr 24, 20233057Expired Provider Enrollment Applications, Change Requests and Revalidations Reminder
Apr 24, 20233056Attention Provider Type 55 (Day and Residential Habilitation Services): Limitations When Billing Procedure Codes T2017 and T2020 on Same Date of Service
Apr 21, 20233055Attention All Providers, Delegates and Staff: Upcoming Training Sessions for May 2023
Apr 18, 20233054Medicaid Services Manual Chapter 1200 Updated
Apr 17, 20233053Attention Provider Types 64 (Hospice) and 65 (Hospice, Long Term Care): Update Regarding Error Code for Outpatient and Inpatient Hospice Claims Submitted With Same Date of Service
Apr 17, 20233052Attention Provider Types 45 (End Stage Renal Disease (ESRD) Facility) and 81 (Hospital Based ESRD Provider): Claims for Dialysis Codes 90945 and 90999 Reprocessed
Apr 14, 20233051Attention All Providers, Delegates, Staff, Credentialing Companies and Third-Party Billers: New Interactive Voice Response Will Enhance Call Center Experience
Apr 12, 20233050Error Codes 5045 and 5047 Updated for Crossover Claim Types (Updated May 12, 2023)
Apr 11, 20233049COVID-19 UNWIND: Certain 1135 Flexibilities to Expire When Public Health Emergency Expires on May 11, 2023
Apr 07, 20233048Attention Provider Type 17, Specialty 181 (Federally Qualified Health Centers (FQHC)): Community Health Worker Rendering Services in FQHC Setting
Apr 06, 20233047Silver State Scripts Board (SSSB) Made Changes to Preferred Drug List (PDL) Effective April 6, 2023
Apr 05, 20233046Attention All Providers, Delegates, Staff, Credentialing Companies and Third-Party Billers: New Verbal Interactive Customer Service Center Experience Coming Soon
Apr 04, 20233045COVID-19 UNWIND: Recipient Redetermination Date Added to Electronic Verification System (EVS) Eligibility Verification Screen
Apr 04, 20233044Error Code 5039 Updated for Crossover Claim Types
Apr 03, 20233043Procedure Code 99215 Limitations and Prior Authorization Requirements
Mar 31, 2023Volume 20 Issue 1COVID-19 UNWIND: Nevada Medicaid and Nevada Check Up News (First Quarter 2023 Provider Newsletter)
Mar 30, 20233042Reminder for Providers Who May Diagnose Autism Spectrum Disorder (Updated April 21, 2023)
Mar 30, 20233041Nevada Medicaid Fee-for-Service to Implement New Program for Prior Authorization Management of Physician Administered Drugs
Mar 29, 20233040Error Codes 5033, 5035, 5036, 5037 and 5038 Updated for Crossover Claim Types
Mar 28, 20233039Attention Provider Type 47 (Indian Health Services (IHS) and Tribal Clinics): Children's Health Insurance Program (CHIP) Claims Reprocessed
Mar 27, 20233038Attention Provider Type 22 (Dental): Updated Details Regarding Certain Dental Benefits Available for Individuals Ages 21 and Older on the Intellectual and Developmental Disabilities Waiver
Mar 23, 20233037Attention All Providers, Delegates and Staff: Upcoming Training Sessions for April 2023
Mar 22, 20233036COVID-19 UNWIND: COVID-19 Diagnostic and Serology Laboratory Testing Procedure Codes Reimbursement Rate
Mar 21, 20233035New Medicare Cost-Sharing Provider Type
Mar 20, 20233034Attention Provider Type 22 (Dental): Certain Dental Benefits Available for Individuals Ages 21 and Older on the Intellectual and Developmental Disabilities Waiver
Mar 20, 20233033Error Codes 5021, 5022, 5023 and 5024 Updated for Crossover Claim Types
Mar 15, 20233032Attention Providers Billing Occupational Therapy or Physical Therapy Services: Use Appropriate Modifiers on Claims When Therapy Assistant Renders Services
Mar 15, 20233031Error Codes 5018, 5019 and 5020 Updated for Crossover Claim Types
Mar 14, 20233030Nevada Medicaid Is Creating New Medicare Cost-Sharing Provider Type
Mar 10, 20233029Attention Provider Types 24 (Advanced Practice Registered Nurses) and 74 (Nurse Midwife): Update Regarding Rates per the Nevada State Plan
Mar 08, 20233028Medicaid Services Manual Chapters Updated
Mar 07, 20233027Error Codes 5010, 5011 and 5013 Updated for Crossover Claim Types
Mar 06, 20233026All Providers Invited to Take Provider Training Survey
Mar 06, 20233025Physician-Administered Drug (PAD) Claims That Denied with Explanation of Benefits Code 8684 Reprocessed
Mar 06, 20233024Claims Submitted by Certain Provider Types for COVID-19 Vaccine and Administration Codes That Denied Have Been Reprocessed
Mar 02, 20233023Attention All Providers: Top 10 Claim Denial Reasons and Resolutions/Workarounds for January 2023 Professional Claims
Mar 02, 20233022Error Codes 5000, 5001, 5002, 5005 and 5006 Updated for Crossover Claim Types
Mar 01, 20233021Attention Provider Type 21 (Podiatrist): Procedure Codes Reopened for Billing
Mar 01, 20233020Attention Provider Types 12 (Hospital, Outpatient) and 43 (Laboratory, Pathology Clinical): Gene Analysis and Testing Procedure Codes Open for Billing
Feb 28, 20233019Vaccination Schedules for Infants, Children and Adults Updated by the Centers for Disease Control and Prevention (CDC)
Feb 24, 20233018Attention All Providers: Translation Services Feature Added to the Public Webpages of Nevada Medicaid Website
Feb 24, 202330172023 Annual New Code Update
Feb 22, 20233016COVID-19 UNWIND: New Unwind Outreach Resources Available
Feb 22, 20233015Provider Type 91 (Pharmacist) May Link to Provider Groups Starting February 22, 2023
Feb 21, 20233014Attention Home and Community Based Waivers Provider Types: Specialty Code Added for Private Case Management
Feb 21, 20233013Updates Regarding National Correct Coding Initiative (NCCI) Quarter 1 2023 Files
Feb 21, 20233012Physician-Administered Drug (PAD) Claims that Denied in Error with Error Code 908 Reprocessed
Feb 17, 20233011Attention All Providers, Delegates and Staff: Upcoming Training Sessions for March 2023
Feb 17, 20233010Attention Provider Types 64 (Hospice) and 65 (Hospice, Long Term Care): Update Regarding Error Code for Outpatient and Inpatient Hospice Claims Submitted With Same Date of Service (Updated information added March 29, 2023)
Feb 16, 20233009Instructions for Requesting a Change in Revenue Code or Procedure Code
Feb 15, 20233008Reminder for All Providers: When Attachments May Be Required On Claims
Feb 13, 20233007Attention Provider Type 90 (Doula Services): Additional Doula Visits Allowed
Feb 13, 20233006Attention Providers Performing Telehealth Services: Audio-only Telehealth Services Allowed
Feb 13, 20233005Medicare Crossover Claims That Paid Greater Than Zero in Error Have Been Reprocessed
Feb 10, 20233004Notice of Public Workshop: Discussion of Process for One-Time Supplemental Payment for Nursing Facilities and Assisted Living Providers
Feb 10, 20233003COVID-19 UNWIND: Eligibility Renewal Timeline Available for Recipients
Feb 10, 20233002Attention Provider Type 56 (Inpatient Rehabilitation and Long Term Acute Care (LTAC) Specialty Hospitals): Error Code 5005 Updated
Feb 10, 20233001Expansion of Medicaid Program for Certain Pregnant Individuals (Updated March 14, 2023)
Feb 09, 20233000Attention Home and Community Based Waivers Provider Types: Specialty Code Added for Private Case Management
Feb 07, 20232999New Emergency Medicaid Only (EMO) Billing Instructions Published
Feb 06, 20232998Drug Use Review (DUR) Board Approves Changes Effective February 6, 2023
Feb 03, 20232997Hospital Presumptive Eligibility Annual Training Calendar Dates and Sign-up Guidelines for 2023
Feb 01, 20232996Attention Provider Type 65 (Hospice, Long Term Care): New Error Codes for Duplicate Inpatient Hospice Claims
Jan 30, 20232995Attention Provider Types 45 (End Stage Renal Disease (ESRD) Facility) and 81 (Hospital Based ESRD Provider): Rates for Dialysis Codes 90945 and 90999 Adjusted for 2023
Jan 30, 20232994COVID-19 General Billing Guide Updated
Jan 27, 20232993Coverage of COVID-19 Over-the-Counter (OTC) Tests
Jan 27, 20232992COVID-19 Covered Services for Uninsured Individuals (COVID-19 Temporary)
Jan 27, 20232991Medicaid Services Manual Chapters Updated
Jan 26, 20232990COVID-19 UNWIND: Providers Asked to Help Prepare Medicaid Members for End of Public Health Emergency
Jan 26, 20232989Attention Provider Type 33 (Durable Medical Equipment, Prosthetics, Orthotics and Supplies): Max Fee and Limitations Updated for Some Durable Medical Equipment Procedure Codes
Jan 23, 20232988Attention Provider Type 33 (Durable Medical Equipment, Prosthetics, Orthotics and Supplies): Rate Implemented for Healthcare Common Procedure Coding System (HCPCS) Code S1040
Jan 20, 20232987Nevada Medicaid Centralized Credentialing Workshop for Providers - Scheduled January 30, 2023
Jan 20, 20232986Notice of Public Workshop: Proposed Changes to Medicaid Services Manual Chapter 100 - Medicaid Program
Jan 20, 20232985Attention All Providers: Top 10 Claim Denial Reasons and Resolutions/Workarounds for December 2022 Claims
Jan 18, 20232984Attention All Providers, Delegates and Staff: Upcoming Training Sessions for February 2023
Jan 17, 20232983Attention All Providers: Nevada Medicaid Will Notify Providers When Linkage Changes Are Made
Jan 17, 20232982Attention All Providers: “Affiliated Providers” Feature Added to Electronic Verification System/Provider Web Portal
Jan 17, 20232981Attention All Providers: Reminder to Review Provider Type Specific Billing Guides
Jan 17, 20232980Medicaid Management Information System Updated with NCCI Quarter 1 2023 Files
Jan 13, 20232979Medicaid Providers Are Invited to Complete a Survey to Assist Nevada Medicaid in Developing a Centralized Credentialing Process
Jan 13, 20232978Attention Provider Type 33 (Durable Medical Equipment, Prosthetics, Orthotics and Supplies): Durable Medical Equipment (DME) Prior Authorization Forms FA-1 and FA-1D Updated
Jan 12, 20232977Attention Provider Types 19 (Nursing Facility) and 65 (Hospice, Long Term Care): State Fiscal Year 2023 Quarter 3 Rate Updates Implemented
Jan 09, 20232976OTC Coverage and Reimbursement Changes Effective January 9, 2023
Jan 06, 20232975Attention Provider Type 12 (Hospital, Outpatient) Specialty 250 (Crisis Stabilization Center): Overview of Crisis Services
Jan 04, 202329741099-Misc. Forms for 2022 Tax Year to be Mailed to Providers by January 31, 2023
Jan 03, 20232973Attention All Providers: COVID-19 Booster Vaccine and Administration Codes Opened or Age Limitations Modified
Jan 03, 20232972Well Check and Sick Visit Combination Policy Update (Updated January 13, 2023)
Jan 03, 20232971Attention Provider Types 25 (Optometrist) and 41 (Optician, Optical Business): Vision Service Procedure Code V2799 Requires Prior Authorization
Jan 03, 20232970Inpatient, Inpatient Crossover and Long Term Care Claims Reprocessed if Recipient Had Hospitalization for Other Health Insurance
Dec 30, 2022Volume 19 Issue 4COVID-19 UNWIND: Nevada Medicaid and Nevada Check Up News (Fourth Quarter 2022 Provider Newsletter)
Dec 30, 20222969Diagnostic Radio-Pharmaceutical Healthcare Common Procedure Coding System (HCPCS) Code A9596 Open for Billing
Dec 29, 20222968Silver State Scripts Board (SSSB) Made Changes to Preferred Drug List (PDL) Effective December 29, 2022
Dec 27, 20222967Attention All Providers: Electronic Verification System (EVS)/Provider Web Portal Administrative Account Password Resets
Dec 27, 20222966Medicaid Services Manual Chapters Updated
Dec 22, 20222965Attention All Providers: Top 10 Claim Denial Reasons and Resolutions/Workarounds for November 2022 Claims
Dec 21, 20222964Catchment Area Zip Codes Updated in Medicaid Management Information System (MMIS)
Dec 21, 20222963Attention All Providers, Delegates and Staff: Upcoming Training Sessions for January 2023
Dec 20, 20222962Provider Type 86 (Specialized Foster Care) Claims Reprocessed
Dec 19, 20222961Attention Provider Type 65 (Hospice, Long Term Care): Claims Denied With Error Code 570 Have Been Reprocessed
Dec 16, 20222960Changes Made to Diabetic Supplies Preferred Product List Effective December 1, 2022
Dec 16, 20222959COVID-19 UNWIND: Nevada Medicaid COVID-19 Public Health Emergency Operational Unwinding Plan Has Been Updated
Dec 14, 202229582023 Annual New Code Update
Dec 12, 20222957Manufacturer’s Invoice Requirements for Durable Medical Equipment (DME) Providers
Dec 12, 20222956Prenatal and Pediatric Vitamin Coverage Changes Effective December 12, 2022
Dec 07, 20222955Monkeypox: Nevada Medicaid Opens Monkeypox Testing and Vaccine Administration Codes for Billing
Dec 07, 20222954Professional Claims Reprocessed if Duplicate Payments Made in Error
Dec 06, 20222953Return Enrollment or Revalidation Letter Issue Resolved
Dec 05, 20222952Attention All Providers: Procedure Codes Released for Vaccine Counseling Visits for Children under 21 Years of Age
Dec 05, 20222951Attention Inpatient Hospitals: Claims for Newborn Admission Revenue Codes 170, 171 and 172 Reprocessed
Dec 02, 20222950Professional and Professional Crossover Claims with Duplicate Details on Current and History Claims Have Been Reprocessed
Nov 30, 20222949National Influenza Vaccination Week 2022
Nov 28, 202229482022 Quadrennial Rate Review Report
Nov 28, 20222947Attention All Providers Billing Third Party Liability
Nov 23, 20222946Attention All Providers: Pfizer and Moderna COVID-19 Booster Vaccine and Administration Codes
Nov 22, 20222945COVID-19 General Billing Guide Updated
Nov 21, 20222944Attention Provider Type 20 (Physician, M.D., Osteopath, D.O.): Limitation Error Codes 5694 and 5695 Will Apply to Claims for Procedure Code H2011
Nov 21, 20222943Revenue Code Must Be Exact Match on Inpatient Claim and Prior Authorization
Nov 21, 20222942Attention All Providers: Recipient Names on Nevada Medicaid ID Cards
Nov 21, 20222941Institutional Claims Billed with Type of Bill Ending in Zero
Nov 14, 20222940Professional and Outpatient Claims Denied in Error with Error Code 6125 Have Been Reprocessed
Nov 10, 20222939Attention Provider Types 19 (Nursing Facility) and 65 (Hospice, Long Term Care): State Fiscal Year 2023 Quarter 2 Rate Updates Implemented
Nov 09, 20222938Attention Applied Behavior Analysis (ABA) Providers: Updated Form FA-11E for ABA Authorization Request
Nov 08, 20222937Attention Behavioral Health Providers: Medicaid Services Manual Chapter 400 and Enrollment Checklists for Qualified Mental Health Associate (QMHA) and Qualified Behavioral Aide (QBA) Updated and Posted Online
Nov 07, 20222936Attention Provider Type 74 (Nurse Midwife): Claims That Denied in Error Have Been Reprocessed
Nov 07, 20222935Some Professional Claims Denied with Error Code 4224 Have Been Reprocessed
Nov 07, 20222934Emergency Medicaid Only Professional Claims That Paid Discharge Date in Error Have Been Reprocessed
Nov 03, 20222933Attention Provider Type 22 (Dentist): A Reminder from the Centers for Disease Control and Prevention (CDC) on the Importance of Dental Line Safety and Disinfection
Oct 31, 20222932Drug Use Review (DUR) Board Approves Changes Effective October 31, 2022
Oct 27, 20222931Medicaid Services Manual Chapter 400 Updated
Oct 26, 20222930Updated Qualifying Clinical Trials (QCTs) Policy
Oct 25, 20222929Attention All Providers: Top 10 Claim Denial Reasons and Resolutions/Workarounds for September 2022 Claims
Oct 24, 20222928Claim Reprocessing Efforts for Inpatient Institutional Claims with Medicare Part A and/or Part B
Oct 21, 20222927Institutional Claims Billed with Type of Bill Ending in Zero
Oct 19, 20222926Attention Providers of Home and Community Based Services (HCBS): Certain Employers of Home Care Workers May Apply for Round 2 of Supplemental Payment
Oct 19, 20222925Attention All Providers: Form FA-29 Required to Report Change in Recipient’s Prior Authorized End Date of Services
Oct 19, 20222924Medicaid Management Information System Updated with NCCI Quarter 4 2022 Files
Oct 18, 20222923Attention Provider Type 38 (Waiver for Individuals with Intellectual and Developmental Disabilities): Rates Updated for Six Procedure Codes
Oct 18, 20222922Indian Health Program Rates Adjusted for Calendar Year 2022
Oct 18, 20222921Annual Rate Adjustment for Provider Type 17 (Special Clinics), Specialty 180 (Rural Health Clinics)
Oct 17, 20222920Attention Some Waiver Providers: Updates to Error Codes 5041, 5042 and 5048
Oct 17, 20222919Current Procedural Terminology Code 90759 Must Be Billed with National Drug Code
Oct 13, 2022Volume 19 Issue 3COVID-19 UNWIND: Nevada Medicaid and Nevada Check Up News (Third Quarter 2022 Provider Newsletter)
Oct 12, 20222918COVID-19 General Billing Guide Updated
Oct 11, 20222917Monkeypox Guidance and Technical Bulletins: Treatment, Pain Management and Severe Manifestations of Monkeypox
Oct 11, 20222916Attention Providers of Behavioral Health Services: Procedure Code 90875 Prior Authorization Requirement
Oct 11, 20222915Reminder for Providers Submitting Physician-Administered Drug Claims: Enter Only National Drug Code Quantity in NDC Quantity Field
Oct 10, 20222914Respiratory Syncytial Virus (RSV) Prophylaxis with Synagis® (Palivizumab)
Oct 07, 20222913Attention Individual Providers: Tax ID Information When Registering for the Electronic Verification System (EVS) Portal
Oct 06, 20222912Silver State Scripts Board (SSSB) Made Changes to Preferred Drug List (PDL) Effective October 6, 2022
Oct 06, 20222911Attention All Providers, Delegates and Staff: Upcoming Training Sessions for December 2022
Oct 03, 20222910COVID-19 UNWIND: Frequently Asked Questions for Managed Care Organizations & Dental Benefits Administrator Plans Updated
Oct 03, 20222909COVID-19 Vaccine Counseling Visits for Children under 21 Years of Age (Updated April 11, 2022, and December 5, 2022)
Sep 30, 20222908Attention Provider Type 55 (Day and Residential Habilitation Services): Claims that Paid or Denied in Error Have Been Reprocessed
Sep 29, 20222907Contact Information Regarding Pharmacy Claims or Physician-Administered Drug (PAD) Claims
Sep 29, 20222906Update to Provider Manual Section: 10.1.3 At-Home Over-the-Counter (OTC) COVID-19 Tests
Sep 28, 20222905Attention Individual Servicing Providers Linked to a Group and Group Providers Billing with Individual Rendering Providers: Report Individual National Provider Identifier (NPI) as Rendering Provider on Claims
Sep 27, 20222904Urgent Message for PASRR Users: Temporary Method to View Recipient History
Sep 26, 20222903COVID-19 UNWIND: Nevada Medicaid COVID-19 Public Health Emergency Operational Unwinding Plan
Sep 26, 20222902Claims without National Drug Codes (NDC) that Denied in Error Have Been Reprocessed
Sep 23, 20222901Attention All Providers: Reminder to Enter Claim Filing Indicator Code on Electronic Claims
Sep 20, 20222900Attention Provider Type 86 (Specialized Foster Care): Claims May Have Paid In Error
Sep 20, 20222899Reminder for All Providers: Providers Limited to One Active Change/Update Application Tracking Number (ATN)
Sep 19, 20222898Attention All Providers: New Novavax COVID-19 Vaccine Code and Administration Codes and Moderna COVID-19 Administration Codes
Sep 19, 20222897Attention All Providers: Moderna COVID-19 Vaccine Code 91311 and Administration Codes 0111A and 0112A Open for Children 6 Months through 5 Years
Sep 19, 20222896Attention All Providers: Claims Impacted by Provider’s Location Status
Sep 14, 20222895Attention All Providers, Delegates and Staff: Upcoming Training Sessions for November 2022
Sep 13, 20222894Attention All Providers: Top 10 Claim Denial Reasons and Resolutions/Workarounds for August 2022 Claims
Sep 09, 20222893Monkeypox: Nevada Medicaid Will Cover Monkeypox Testing and Vaccine Administration Codes
Sep 08, 20222892Outpatient, Professional and Medicare Crossover Claims for Procedure Codes A0160, T1015 and T1023 Reprocessed
Sep 02, 20222891Attention All Providers: Pfizer COVID-19 Vaccine Code 91308 and Administration Codes 0081A, 0082A and 0083A Open for Children 6 Months through 4 Years
Sep 02, 20222890Non-emergent Hospital or Level of Care Transfers Require Authorization Prior to Transfer
Sep 02, 20222889Reminder: Rate Review Surveys for Certain Provider Types
Sep 01, 20222888Attention Provider Type 24 (Advanced Practice Registered Nurse): Newborn Hearing Screen Procedure Code 92558 (Updated October 20, 2022)
Aug 31, 20222887Attention Provider Type 33 (Durable Medical Equipment, Prosthetics, Orthotics and Supplies): Reminder to Use Modifiers Only When Appropriate
Aug 31, 20222886Attention Provider Type (PT) 74 (Nurse Midwife): Additional Procedure Codes That Can Be Billed under PT 74 (Updated October 20, 2022)
Aug 29, 20222885Attention Dental Services Providers: Claims for Dental Procedure Codes Reprocessed
Aug 29, 20222884Attention Provider Type 58 (Home and Community Based Waiver for Persons with Physical Disabilities): Use Modifier U1 with Procedure Code S5165 to Include Assessment Fee Plus Travel Cost
Aug 29, 20222883Medicaid Services Manual Chapter 1200 Updated
Aug 26, 20222882Update: Claim Denials for Medication-Assisted Treatment (MAT) Services with an Opioid Use Disorder (OUD) Diagnosis
Aug 26, 20222881Evaluation and Management Procedure Codes 99245 and 99215 (Updated September 14, 2022)
Aug 25, 20222880Attention All Providers: Reminder to Ensure Date of Service and Header Date Range Match on Claim
Aug 24, 20222879Attention All Providers, Delegates and Staff: Upcoming Training Sessions for October 2022
Aug 23, 20222878Attention Provider Type 20 (Physician, M.D., Osteopath, D.O.): Claims for 2022 Anesthesia Procedure Codes Reprocessed
Aug 22, 20222877COVID-19 UNWIND: COVID-19 Vaccine and Vaccine Administration Codes Closed for Provider Type 22 (Dentist)
Aug 18, 20222876Attention All Providers: Providers Limited to One Active Change/Update Application Tracking Number (ATN)
Aug 17, 20222875COVID-19 Billing Guides Updated
Aug 17, 20222874Public Notice: Rescission of State Plan Amendment 22-0010 (Quarterly Supplemental Payment to Certain Home and Community-Based Services Provider Types)
Aug 16, 20222873Technical Bulletin: Monkeypox Virus Vaccine Guidance and Recommendations
Aug 16, 20222872Claims for Chemotherapy and Administration Related Codes Denied in Error
Aug 15, 20222871Attention All Providers: Top 10 Claim Denial Reasons and Resolutions/Workarounds for July 2022 Claims
Aug 12, 20222870Attention Provider Type 38 (Home and Community Based Services (HCBS) Waiver for Individuals with Intellectual and Developmental Disabilities): Online Enrollment Application Group Linkage Options Enhanced
Aug 12, 20222869Attention All Providers: Provider Enrollment Group Training Videos Available
Aug 11, 20222868Drug Use Review (DUR) Board Approves Changes Effective August 1, 2022
Aug 11, 20222867COVID-19 UNWIND: Managed Care Organizations and Dental Benefits Administrator Plans - Frequently Asked Questions
Aug 10, 20222866Attention Provider Type 22 (Dentist): Claim Processing for Dental Services Rendered in an Inpatient Setting
Aug 10, 20222865Attention Behavioral Health Providers: Updated Form FA-11B for Mental Health Request for Partial Hospitalization Program (PHP) and Intensive Outpatient Program (IOP) Services
Aug 09, 20222864Inpatient Crossover Claims and Outpatient Crossover Claims that Paid Incorrectly Have Been Reprocessed
Aug 08, 20222863Attention Provider Type 12 (Hospital, Outpatient): Duplicate Outpatient Crossover Claims Reprocessed
Aug 02, 20222862Attention Provider Type 12 (Hospital, Outpatient): Duplicate Outpatient Crossover Claims
Aug 02, 20222861Attention Providers Who Bill Crossover Claims Electronically via 837I or 837P Transactions with Claims Adjustment Reason Code (CARC) 132: Claims Denied in Error Have Been Reprocessed
Aug 02, 202228602023 Annual ICD-10-CM Diagnosis Code and ICD-10-PCS Inpatient Procedure Code Updates
Aug 01, 20222859Claims for Radio-Pharmaceutical Codes
Jul 29, 20222858Attention Behavioral Health Providers: Licensed Master Social Worker (LMSW) Post-Graduate Interns May Enroll as a Qualified Mental Health Professional (QMHP) (Updated December 8, 2022)
Jul 29, 20222857CDC Outreach: Clinical Considerations for Monkeypox in Children and Adolescents
Jul 27, 20222856COVID-19 UNWIND: New “Update My Address” Website for Nevada Medicaid Recipients
Jul 26, 20222855Attention All Providers, Delegates and Staff: Upcoming Training Sessions for September 2022
Jul 25, 20222854Attention Provider Type 58 (Home and Community Based Waiver for Persons with Physical Disabilities): Specialty 204 (Home Delivered Meals) Providers May Bill Procedure Code S5170
Jul 22, 20222853State Plan Amendment Approval of Provider Types 89 – Community Health Workers, 90 – Doulas, and 91 – Licensed Pharmacists
Jul 22, 20222852Toolkit Available to Help Pediatricians and Family Physicians to Increase Confidence in and Uptake of COVID-19 Vaccines for Youth
Jul 22, 20222851Medicaid Services Manual Chapters Updated
Jul 21, 20222850Attention All Providers: Existing COVID-19 Testing Codes Have Been Opened for Additional Provider Types
Jul 21, 20222849Silver State Scripts Board (SSSB) Made Changes to Preferred Drug List (PDL) Effective July 20, 2022
Jul 20, 20222848Attention Northern Nevada Providers: LIBERTY Presents Free Adult Dental Days (Updated July 26, 2022)
Jul 20, 20222847Attention Provider Type 20 (Physician, M.D., Osteopath, D.O.): Reminder of Service Limitations for Procedure Code H2011
Jul 20, 20222846New Error Codes Will Validate Covered Days on Inpatient and Long-Term Care Claims
Jul 18, 20222845Ultrasound Scan Procedure Codes 76827 and 76828
Jul 14, 20222844COVID-19 UNWIND: New COVID-19 Unwind Resources Available
Jul 14, 20222843CDC ADVISORY: Recent Reports of Human Parechovirus (PeV) in the United States - 2022
Jul 13, 20222842Attention Provider Type 14 (Behavioral Health Outpatient Treatment) and 82 (Behavioral Health Rehabilitative Treatment): Initial 16-Hour Competency Training Program Requirements for Qualified Mental Health Associates and Qualified Behavioral Aides
Jul 12, 20222841Attention Provider Type 64 (Hospice): Claims that Paid Federal Fiscal Year (FFY) 2021 Rates Have Been Reprocessed
Jul 12, 20222840Medicaid Services Manual Chapters Updated
Jul 11, 20222839Attention Provider Types 30 (Personal Care Services - Provider Agency) and 83 (Personal Care Services - Intermediary Service Organization): Electronic Visit Verification (EVV) Claims Reprocessed
Jul 07, 20222838COVID-19 UNWIND: Impact on Nevada Medicaid 1135 Flexibilities When Public Health Emergency Expires
Jul 07, 20222837Attention All Providers, Delegates and Staff: Upcoming Training Sessions for August 2022
Jul 07, 20222836Attention Provider Types 19 (Nursing Facility) and 65 (Hospice, Long Term Care): State Fiscal Year 2023 Quarter 1 Rate Updates Implemented
Jul 07, 20222835Attention Provider Types 60 (School Health Services) and 85 (Applied Behavior Analysis): Applied Behavior Analysis Services Can Be Billed With More Than One Place of Service Code
Jul 06, 2022Volume 19 Issue 2COVID-19 UNWIND: Nevada Medicaid and Nevada Check Up News (Second Quarter 2022 Provider Newsletter)
Jul 06, 20222834Nevada Medicaid and Nevada Check Up Managed Care Organization (MCO) 2022 Open Enrollment
Jul 06, 20222833Professional Claims with Inpatient Place of Service
Jul 05, 20222832Requirements Regarding National Provider Identifier of Attending and Ordering, Prescribing or Referring Provider on Claims
Jul 05, 20222831Attention Provider Type 38 (Waiver for Individuals with Intellectual and Developmental Disabilities): Multiple Jobs and Day Training (JDT) Services Allowed Per Day
Jul 05, 20222830Claims for Anesthesia Codes for 2022 That Denied Have Been Reprocessed
Jul 01, 2022