Nevada Medicaid and Nevada Check Up News (Fourth 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]

Notifications

NOTIFICATION: The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. to midnight Pacific Time, Tuesday, February 20, 2024, for scheduled maintenance. This maintenance period replaces the maintenance scheduled for Monday, February 19, 2024, due to the Presidents Day Holiday.
  • Secure Provider Web Portal (Electronic Verification System – EVS), which includes:
    • Recipient Eligibility
    • Provider Claim Appeals
    • Prior Authorization (PA) system
    • Claims Submission
  • Online Provider Enrollment (OPE)
  • Gabby®, which includes:
    • Customer Service Center (877) 638-3472
    • Automated Response System (ARS) (800) 942-6511
  • Real time CAQH/CORE EDI eligibility and claim verification
  • Provider PASRR
  • Trading Partner File Transfer (EDI/SFTP)
  • Business Partner File Transfer (EDI/SFTP)

URGENT NOTIFICATION: Physician Administered Drug (PAD) claims may be experiencing a host eligibility error. The impacted claims will be reprocessed automatically. No action is needed by providers.

Unwinding COVID-19 Information

Known System Issues-Click HERE

Feedback Requested Regarding the Gabby™ Interactive Voice Response (IVR) System Survey

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

Top 10 Claim Denial Reasons and Resolutions/Workarounds for November 2023 Professional Claims. See Web Announcement 3249.

Top Prior Authorization Denial Reasons for the Fourth Quarter of 2023. See Web Announcement 3280.

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

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

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  • Waiver Providers - Announcements related only to Waiver Providers
DateAnnouncement NumberTopic
Feb 16, 20243281Attention Provider Type 63 (Residential Treatment Center/Psychiatric Residential Treatment Facility): Initial Prior Authorization Requests for Youth
Feb 16, 20243280Attention All Providers: Top Prior Authorization Denial Reasons for the Fourth Quarter of 2023
Feb 15, 20243279COVID-19 UNWIND: Attention All Providers and Community Partners: Free Medicaid Resources to Assist Recipients
Feb 15, 202432782024 Annual New Code Update
Feb 14, 20243277Enrollment Begins for Certified Community Behavioral Health Centers (CCBHCs) Statewide
Feb 07, 20243276Attention Provider Type 33 (Durable Medical Equipment, Prosthetics, Orthotics and Supplies): Catheter Procedure Codes Limitation
Feb 06, 20243275Attention Provider Type 29 (Home Health Agency and Private Duty Nursing Services): 15 Percent Rate Increase Effective January 1, 2024
Feb 05, 20243274Drug Use Review (DUR) Board Approves Changes Effective February 5, 2024
Feb 05, 20243273Updates Made to Prior Authorization Policy of Continuous Glucose Monitors (CGMs)
Feb 02, 20243272Attention All Providers: New Call Center Virtual Hold/Callback Option
Feb 01, 20243271Urgent Announcement: Professional Crossover Claims Reprocessing Effort Has Been Cancelled
Jan 30, 20243270Rate Increases for Personal Care Services (PCS) and PCS-Like Services (Updated February 12, 2024)
Jan 29, 20243269Professional and Professional Crossover Claims With Duplicate Details on History and Current Claims That Paid in Error Have Been Reprocessed
Jan 29, 20243268Outpatient and Professional Claims Billed With Modifier 51 Reprocessed
Jan 25, 20243267Prior Authorization Requirements for Laboratory Services Used for Biomarker Testing
Jan 25, 20243266Attention All Providers, Delegates and Staff: Upcoming Training Sessions for February 2024
Jan 23, 20243265Attention Marriage and Family Therapists (MFT) and Mental Health Counselors (MHC) Delivering Services to Dual Eligible Recipients and Behavioral Health Providers Delivering Intensive Outpatient Programs (IOP) to Dual Eligible Recipients
Jan 23, 20243264Attention Provider Types 19 (Nursing Facility) and 65 (Hospice, Long Term Care): State Fiscal Year 2024 Quarter 3 Rate Updates Implemented
Jan 23, 20243263Attention Provider Types 60 (School Health Services (SHS)) and 85 (Applied Behavior Analysis (ABA)): Rate Updates for Some Applied Behavior Analysis Services. (Updated February 5, 2024)
Jan 18, 20243262Recipient Eligibility for Postpartum Care Services
Jan 11, 20243261Crossover Claims That Had Negative Payment Amounts from Medicare Have Been Reprocessed
Jan 10, 20243260Attention Provider Types 10 (Outpatient Surgery, Hospital Based) and 46 (Ambulatory Surgical Centers): Anesthesia Procedure Codes 01937-01942 Cannot Be Billed
Jan 09, 20243259Claims for Mammography Procedure Codes 77063 and 77067 Submitted With Modifiers TC or 26 That Denied In Error Have Been Reprocessed
Jan 08, 20243258Attention Federally Qualified Health Centers (FQHC) Billing Encounter Codes Under Fee-For-Service (FFS) Medicaid
Jan 05, 20243257Attention Provider Type 20 (Physician, M.D., Osteopath, D.O.): Claims for Procedure Code 77063 With Modifier TC May Have Denied With Error Code 4014
Jan 05, 20243256Updates to Coverage and Limitations for Obstetric Admissions (Updated January 22, 2024)
Jan 05, 20243255Medicaid Services Manual Chapters Updated
Jan 03, 20243254Attention Provider Types 30 (Personal Care Services - Provider Agency) and 83 (Personal Care Services - Intermediary Service Organization): Authorization Request for Personal Care Services (PCS) Form FA-24 and Instructions Updated
Jan 03, 202432531099-Misc. Forms for 2023 Tax Year to be Mailed to Providers by January 31, 2024
Jan 02, 20243252Drug Use Review (DUR) Board Approves Changes for Physician Administered Drugs (PAD)
Jan 02, 20243251Drug Use Review (DUR) Board Approves Changes Effective January 2, 2024
Dec 28, 2023Volume 20 Issue 4COVID-19 UNWIND: Nevada Medicaid and Nevada Check Up News (Fourth Quarter 2023 Provider Newsletter)
Dec 28, 20233250Silver State Scripts Board (SSSB) Made Changes to Preferred Drug List (PDL) Effective December 28, 2023
Dec 26, 20233249Attention All Providers: Top 10 Claim Denial Reasons and Resolutions/Workarounds for November 2023 Professional Claims
Dec 21, 20233248COVID-19 UNWIND: Recipient Nevada Medicaid Disenrollments and Procedural Denials to Restart Effective January 1, 2024
Dec 21, 20233247URGENT ANNOUNCEMENT: Professional Crossover Claims Reprocessing Effort on Hold
Dec 20, 20233246Error Codes 5620, 5633 and 5681 Updated for Crossover Claim Types
Dec 20, 20233245Attention Behavioral Health Providers: Service Limitations for Outpatient Psychotherapy Reset January 1 of Each Year
Dec 20, 20233244False Claims Act Initial Certification or Recertification Letters (Updated January 16, 2024)
Dec 19, 20233243Attention Provider Type 64 (Hospice): Federal Fiscal Year (FFY) 2024 Annual Rates Update
Dec 18, 20233242Updated American Dental Association (ADA) Dental Claim Form to be Released January 1, 2024
Dec 18, 20233241COVID-19 UNWIND: COVID-19 Administration and Vaccine Procedure Code Emergency Use Authorization and Revocation Updates
Dec 18, 202332402024 Annual New Code Update
Dec 15, 20233239Attention Provider Type 19 (Nursing Facilities): Medicaid Estate Recovery Changes Effective January 1, 2024
Dec 14, 20233238Attention All Providers, Delegates and Staff: Upcoming Training Sessions for January 2024
Dec 14, 20233237Claims for Vaccine Procedure Codes That Require a National Drug Code
Dec 12, 20233236Indian Health Program Claims That Paid Incorrect Rate Have Been Reprocessed
Dec 12, 20233235Professional and Institutional Crossover Claims Denied With Error Code 6125 Have Been Reprocessed
Dec 11, 20233234Attention Pre-Admission Screening Resident Review (PASRR) Portal Users: System Upgrades Will Help Providers Monitor Status of Tickets
Dec 11, 20233233Error Codes 5599 and 5632 Updated for Crossover Claim Types
Dec 08, 20233232Reimbursement for Family Caregivers of Medicaid Recipients with Medically Complex Conditions (Updated January 2, 2024)
Dec 04, 20233231Attention Provider Type 20 (Physician, M.D., Osteopath, D.O.): Procedure Code 64999 Denied In Error With Error Code 4014
Dec 04, 20233230Applied Behavior Analysis (ABA) Authorization Reconsideration Timeline Update
Dec 01, 202332291099-Misc. Forms for 2023 Tax Year to be Mailed to Providers by January 31, 2024; Providers May Sign Up to Download Electronic 1099s
Dec 01, 20233228Private Hospital Inpatient and Outpatient Services Assessment Rates
Nov 30, 20233227Attention All Providers: Top Prior Authorization Denial Reasons for the Third Quarter of 2023
Nov 28, 20233226Attention Provider Type 48 (Home and Community Based Waiver for the Frail Elderly): Error Code 5041 Updated to Apply Only to Procedure Code S5120
Nov 27, 20233225Certified Community Behavioral Health Center (CCBHC) Standards Training for Prospective Medicaid Enrollment Scheduled for November 30, 2023
Nov 22, 20233224Error Codes 5631, 5645, 5646 and 6112 Updated for Crossover Claim Types
Nov 22, 20233223Attention Provider Type 60 (School Health Services): Audiology Procedure Codes Open for Billing
Nov 22, 20233222Physician-Administered Drug (PAD) Claims With Host Eligibility Error Have Been Reprocessed
Nov 21, 20233221Attention All Providers: Top 10 Claim Denial Reasons and Resolutions/Workarounds for October 2023 Professional Claims
Nov 20, 20233220Notice of Revised Carrier Premium Reduction Targets for Plans Established in NRS 695K
Nov 20, 20233219Online Provider Enrollment (OPE) Updated to Allow More Than One License/Certification Number
Nov 20, 20233218Attention All Providers: Claims for Procedure Code H0004 Impacted by Limitation Error Codes 5690 and 5691
Nov 17, 20233217Attention All Nevada Medicaid Providers: New Provider Training Registration Portal Will Implement in January 2024
Nov 14, 20233216Patient Responsibility Adjudicated Incorrectly on Professional Crossover Claims
Nov 09, 20233215Error Code 6140 Updated for Outpatient Claim Types
Nov 08, 20233214Error Codes 5617, 6114, 6117 and 6511 Updated for Crossover Claim Types
Nov 07, 20233213Attention Provider Types 19 (Nursing Facility) and 65 (Hospice, Long Term Care): State Fiscal Year 2024 Quarter 2 Rate Updates Implemented
Nov 07, 20233212COVID-19 UNWIND: Dental Providers No Longer Allowed to Administer COVID-19 Vaccines
Nov 06, 20233211Attention Provider Types 13 (Psychiatric Hospital, Inpatient), 11 (Hospital, Inpatient) and 63 (Residential Treatment Center/Psychiatric Residential Treatment Facility): Prior Authorization Forms Updated
Nov 06, 20233210Updates Regarding National Correct Coding Initiative (NCCI) Quarter 4 2023 Files
Nov 03, 20233209Error Code 3030 Update for Physician Administered Drug (PAD) Claims
Nov 03, 20233208Attention Provider Types 20 (Physician, M.D. Osteopath, D.O.), 25 (Optometrist) and 41 (Optician, Optical Business): Primary and Add-on Procedure Codes for Lenses
Nov 03, 20233207Prescription Discount Cards
Nov 02, 20233206COVID-19 UNWIND: Claims Denied Due to Recipient Ineligibility Have Been Reprocessed
Nov 01, 20233205Error Codes 5595 and 5601 Updated for Outpatient Claim Types
Nov 01, 20233204Error Codes 5595, 5697, 5698, 5714, 6125, 6127 and 6131 Updated for Crossover Claim Types (Updated November 17, 2023)
Nov 01, 20233203Attention Provider Type 64 (Hospice): Claims With Revenue Code 0650 That Paid In Error Have Been Reprocessed
Oct 31, 20233202Attention Provider Type 22 (Dentist): Service Limitations Updated for Alveoloplasty Procedure Codes
Oct 30, 20233201Prior Authorization Process for Zolgensma® (onasemnogene abeparvovec-xioi)
Oct 26, 20233200Error Code 5621 Updated for Outpatient Claim Types
Oct 26, 20233199Error Code 5640 Updated for Crossover Claim Types
Oct 24, 20233198Electronic Visit Verification (EVV) Informational Seminar Series
Oct 24, 20233197Attention Provider Types 20 (Physician, M.D. Osteopath, D.O.), 25 (Optometrist) and 41 (Optician, Optical Business): Error Codes Applicable to Procedure Code V2745
Oct 24, 20233196Attention Provider Type 74 (Nurse Midwife): Procedure Code 59020 May Be Billed With Modifiers 26 and TC
Oct 23, 20233195Error Codes 6120, 6501 and 6510 Updated for Crossover Claim Types
Oct 20, 20233194Attention All Providers, Delegates and Staff: Upcoming Training Sessions for November 2023
Oct 19, 20233193Reminder Regarding Services Provided Through School Health Services (Provider Type 60)
Oct 17, 20233192Update Regarding Provider Type 55 (Day and Residential Habilitation Services): Specialty 315 for Day Habilitation and Specialty 316 for Residential Habilitation Are Now Available for Enrollment
Oct 17, 20233191Attention Provider Types 20 (Physician, M.D. Osteopath, D.O.), 25 (Optometrist) and 41 (Optician, Optical Business): Claims for Procedure Code V2020 Reprocessed
Oct 16, 20233190Attention Personal Care Services Providers: Functional Assessment Service Plan (FASP) May Be Accessed, Downloaded and Printed
Oct 16, 20233189Physician-Administered Drug (PAD) Claims Reprocessing Effort
Oct 13, 20233188Attention All Providers: Top 10 Claim Denial Reasons and Resolutions/Workarounds for September 2023 Professional Claims
Oct 12, 20233187Silver State Scripts Board (SSSB) Made Changes to Preferred Drug List (PDL) Effective October 12, 2023
Oct 11, 20233186Action Required by November 30, 2023: Urgent Update Regarding Changes to Electronic Visit Verification (EVV) Billing Process
Oct 11, 20233185Error Codes 5685 and 6104 Updated for Crossover Claim Types
Oct 09, 20233184COVID-19 UNWIND: URGENT Announcement for All Providers: Updated Billing Instructions Regarding Medicaid Recipient Reinstatement
Oct 06, 20233183Error Codes Applicable to Shoe-Related Procedure Codes A5500, A5501 and L3332 Have Been Updated
Oct 06, 20233182Attention Provider Type 12 (Hospital, Outpatient): Error Code 5674 Applicable to Procedure Code A4410 When Limitation Is Exceeded
Oct 04, 20233181Medicaid Management Information System Updated with NCCI Quarter 4 2023 Files
Oct 04, 20233180Prior Authorization Requirement Updated for Transplant and Infusion/Chemotherapy Procedure Codes
Oct 03, 20233179COVID-19 UNWIND: Emergency Use Authorization Revoked for Janssen Vaccine Procedure Codes
Oct 03, 20233178Prior Authorization Requirements Removed for Hernia Procedure Codes
Oct 02, 20233177Professional Crossover Claims Denied with Error Code 1008 Have Been Reprocessed
Oct 02, 2023Volume 20 Issue 3Nevada Medicaid and Nevada Check Up News (Third Quarter 2023 Provider Newsletter)
Sep 29, 20233176Respiratory Syncytial Virus (RSV) Prophylaxis with Synagis® (palivizumab)
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, 20233165COVID-19 UNWIND: URGENT Announcement for All Providers: Medicaid Member Reinstatement (Updated October 9, 2023)
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 (Updated September 29, 2023)
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 (Updated December 13, 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<