Nevada Medicaid and Nevada Check Up News (Fourth Quarter 2022 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

The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. to midnight Pacific Time Sunday, March 26, 2023, for scheduled maintenance:
  • Secure Provider Web Portal (Electronic Verification System – EVS)
  • Online Provider Enrollment (OPE)
  • Online Provider Claim Appeals
  • Online Prior Authorization (PA) system
  • Online Claims Submission
  • Audio Response System (ARS) (800-942-6511)
  • Real time CAQH/CORE EDI eligibility and claim verification
  • Provider PASRR

Nevada Medicaid COVID-19

Nevada Health Response

Known 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.

Top 10 Claim Denial Reasons and Resolutions/Workarounds for January 2023 Professional Claims. See Web Announcement 3023.

Top Prior Authorization Denial Reasons for the First Quarter of 2021. See Web Announcement 2505.

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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  • Dental/Orthodontia - Announcements related only to Dental/Orthodontia
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  • Personal Care Services (PCS) - Announcements related only to Personal Care Services
  • Durable Medical Equipment (DME) - Announcements related only to Durable Medical Equipment
  • Behavioral Health - Announcements related only to Behavioral Health
  • Waiver Providers - Announcements related only to Waiver Providers
DateAnnouncement NumberTopic
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): New Error Code for Outpatient and Inpatient Hospice Claims Submitted With Same Date of Service
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, 20222829Attention All Providers: Please Distribute Through Social Media
Jul 01, 20222828Attention All Providers: New Recipient Medicaid ID Cards Are Coming Soon
Jul 01, 20222827New Provider Type Created for Pharmacist Services
Jul 01, 20222826New Electronic Claim Billing Instructions for Physician-Administered Drug (PAD) 340B Claims Effective July 1, 2022
Jul 01, 20222825New Electronic Claim Billing Instructions for Pharmacy Point-of-Sale (POS) 340B Claims Effective July 1, 2022
Jul 01, 20222824Reminder: Hysterectomy Acknowledgement Form Required with Claims for Hysterectomy-Related Laparoscopy Surgical Codes Effective July 1, 2022
Jul 01, 20222823Attention All Providers: Pfizer COVID-19 Booster Administration Code 0074A Open for Children 5 through 11
Jun 30, 20222822Provider Documentation Reminders
Jun 30, 20222821Attention Provider Types 19 (Nursing Facility) and 65 (Hospice, Long Term Care): Update Regarding Claims Impacted by State Fiscal Year 2022 Quarter 2 Rate Updates
Jun 30, 20222820Medicaid Management Information System Updated with NCCI Quarter 3 2022 Files
Jun 29, 20222819Technical Bulletin: Pediatric COVID-19 Vaccines Recommended for Children Aged 6 Months – 5 Years
Jun 29, 20222818Ocular Procedure Codes V2623, V2625, V2627 and V2628 Will No Longer Deny with Error Code 5579
Jun 28, 20222817Rate Review Surveys for Certain Provider Types
Jun 24, 20222816Attention All Providers and Pharmacies: Pharmacy Systems Unavailable During Pharmacy Benefits Management (PBM) Transition
Jun 21, 20222815Attention Nursing, Hospice, Residential Treatment and Intermediate Care Facilities: Inpatient Crossover and Outpatient Crossover Claims That Denied With Error Code 4239 Have Been Reprocessed
Jun 20, 20222814New and Clarified Statuses for Provider Enrollment Applications
Jun 20, 20222813Attention All Providers: Moderna COVID-19 Booster Vaccine Code and Administration Code
Jun 20, 20222812Attention All Providers: Update on Claims Denied with Error Code 2504 When Other Insurance Applied to Co-Pay or Co-Insurance
Jun 20, 20222811Update Regarding Behavioral Health Claims Denied if Recipient Was Covered by Medicare
Jun 17, 20222810Website Changes Will Reflect Pharmacy Benefits Management Transition Effective July 1, 2022
Jun 17, 20222809Some Claims Adjudicated with Error Code 6511 Have Been Reprocessed
Jun 17, 20222808Claims That Should Have Denied for Medicare or Private Insurance Coverage Have Been Reprocessed
Jun 16, 20222807New Provider Type to be Created for Pharmacist Services
Jun 15, 20222806Know COVID-19 Vaccine “Expiration” AND “Beyond Use” Dates
Jun 14, 20222805Attention All Providers, Delegates and Staff: Upcoming Training Sessions for July 2022
Jun 13, 20222804Attention Provider Type 17 (Special Clinic) Specialty 174 (Public Health Clinic): Education and Training Procedure Codes Open for Billing
Jun 10, 20222803Attention Certified Community Behavioral Health Centers (CCBHCs): Bill with Place of Service Code 15 for Mobile Crisis Services
Jun 10, 20222802Attention Provider Type 22 (Dentist): Dental Fee-for-Service Coverage, Limitations and Prior Authorization Requirements Updated with 2022 Procedure Codes
Jun 09, 20222801New Electronic Claim Billing Instructions for Physician-Administered Drug (PAD) 340B Claims Effective July 1, 2022
Jun 09, 20222800New Electronic Claim Billing Instructions for Pharmacy Point-of-Sale (POS) 340B Claims Effective July 1, 2022
Jun 08, 20222799URGENT for All Providers: System Upgrades Will Impact Availability of the Provider Web Portal and Online Provider Enrollment
Jun 07, 20222798Attention Providers Billing Surgical Procedures: List Current Procedural Terminology (CPT) Codes from Highest to Lowest Relative Value
Jun 07, 20222797Attention Provider Type 55 (Day and Residential Habilitation Services): Some Claims that Adjudicated Incorrectly Have Been Reprocessed
Jun 06, 20222796COVID-19 Billing Guides Updated
Jun 06, 20222795Drug Use Review (DUR) Board Approves Changes Effective June 6, 2022
Jun 02, 20222794Attention Provider Type 28 (Pharmacy): Vaccine Administration Incentive for Expanded Use of Pfizer BioNTech COVID-19 Vaccine Booster Dose for Children 5 through 11
Jun 01, 20222793Emergency Use Authorization Revoked for Monoclonal Antibody Injection Code Q0247 and Infusion Codes M0247 and M0248
Jun 01, 20222792Hysterectomy Acknowledgement Form Required with Claims for Hysterectomy-Related Laparoscopy Surgical Codes Effective July 1, 2022
May 31, 20222791Attention All Providers: Physician-Administered Drug Claims and Point-of-Sale Drug Claims Impacted by Pricing Load Issue Are Being Reprocessed
May 27, 20222790Attention Provider Type 17 (Special Clinics) Specialty 166 (Family Planning): Additional Procedure Codes Opened for Billing
May 25, 20222789It’s Not Me or Is It?: Implicit Bias in Medicine ECHO Session Scheduled for May 31, 2022
May 25, 20222788Attention All Providers: Clinical Records Procurement for Encounter Data Validation
May 24, 20222787Attention Provider Type 12 (Hospital, Outpatient): Claims for Sedation Services Procedure Codes 99151, 99152 and 99153 Reprocessed
May 19, 20222786Attention All Providers, Delegates and Staff: Upcoming Training Sessions for June 2022
May 18, 20222785Reminders to Out-of-State and Catchment Area Providers Enrolling with Nevada Medicaid
May 17, 20222784Attention Provider Type 22 (Dentist) Specialties 80 (Oral Surgery) and 170 (Maxillofacial Surgery): Place of Service (POS) Code 21 Billing Option Available
May 13, 20222783Updated Information on Availability and Use of Treatments for Outpatients with Mild to Moderate COVID-19 Who are at Increased Risk for Severe Outcomes of COVID-19
May 12, 20222782Notice of Public Workshop for Nevada Administrative Code (NAC) Chapter 439A - Planning for the Provision of Health Care
May 10, 20222781Public Notice: COVID-19 American Rescue Plan Act (ARPA) State Plan Amendments
May 10, 20222780Recommendations for Adenovirus Testing and Reporting of Children with Acute Hepatitis of Unknown Origin
May 10, 20222779Attention Provider Type 33 (Durable Medical Equipment, Prosthetics, Orthotics and Supplies): Update Regarding Wheelchair and Wheelchair Accessory Claims Reprocessing
May 04, 20222778URGENT: All Providers Encouraged to Take Small Business Impact Survey by May 9, 2022, Regarding Collection of Provider Data
May 04, 20222777Attention Provider Type 28 (Pharmacy): Additional Details Regarding Nevada Medicaid Fee-for-Service Transition of Pharmacy Benefits Management to Magellan Medicaid Administration Inc. on July 1, 2022
May 04, 20222776Attention Provider Type 33 (Durable Medical Equipment, Prosthetics, Orthotics and Supplies): Ordering and Pricing Documents for Durable Medical Equipment
May 03, 20222775Attention Provider Type 22 (Dentist): Dental Imaging Claims with Procedure Code D9310
Apr 29, 20222774Medicaid Services Manual Chapters Updated
Apr 29, 20222773Attention Provider Types 11 (Hospital, Inpatient) and 64 (Hospice): Update Regarding Pediatric Hospice Claims with Overlapping Dates of Service
Apr 29, 20222772Attention Provider Type (PT) 34 Specialty 28 Occupational Therapy (OT) Providers in a Behavioral Health Setting
Apr 29, 20222771Use Modifier KX or Condition Code 45 for Claims for Transgender Individuals
Apr 25, 20222770Attention All Providers: Monoclonal Antibody Codes Opened for Treatment of COVID-19 Infection (Updated June 16, 2022)
Apr 25, 20222769Attention All Providers: Pfizer COVID-19 Vaccine Code and Administration Codes
Apr 22, 20222768Attention All Providers, Delegates and Staff: Upcoming Training Sessions for May 2022
Apr 22, 202227672022 Annual New Code Update
Apr 20, 20222766Instructions Updated for Submitting Claims for Exception Batch Processing Using the Provider Web Portal
Apr 20, 20222765Attention Provider Type 28 (Pharmacy): Claims Impacted by Pricing Load Issue will be Reprocessed
Apr 20, 20222764Attention All Providers: VEKLURY™ (remdesivir) Antiviral Medication for COVID-19 Omicron Variant Treatment
Apr 20, 20222763Attention Provider Type 33 (Durable Medical Equipment, Prosthetics, Orthotics and Supplies): Claims Reprocessed
Apr 20, 20222762New Chatbot Provides Self-Service Option to Answering Providers’ Frequently Asked Questions
Apr 15, 2022Volume 19 Issue 1COVID-19 UNWIND: Nevada Medicaid and Nevada Check Up News (First Quarter 2022 Provider Newsletter)
Apr 14, 20222761Attention Provider Type 28 (Pharmacy): Nevada Medicaid Fee-for-Service Transition of Pharmacy Benefits Management to Magellan Medicaid Administration Inc. on July 1, 2022
Apr 14, 20222760Attention Provider Type 28 (Pharmacy): Second COVID-19 Vaccine Booster Dose
Apr 14, 20222759Attention All Providers: Reimbursement Rate Update for COVID-19 Vaccine Administration Codes
Apr 11, 20222758Attention All Providers: Prior Authorization Contact Information and Self-Service Tools
Apr 11, 20222757Attention Provider Type 86 (Specialized Foster Care): Update on Claims for Procedure Codes H2019 and H2019 with Modifier HT that Denied (Updated June 7, 2022)
Apr 11, 20222756Use Modifier QW on Claims when the Clinical Laboratory Improvement Amendments Test Waiver Applies to the Procedure Code
Apr 06, 20222755Attention Provider Types 19 (Nursing Facility) and 65 (Hospice, Long Term Care): State Fiscal Year 2022 Quarter 4 Rate Updates Implemented
Apr 01, 20222754Medicaid Management Information System Updated with NCCI Quarter 2 2022 Files
Mar 31, 20222753New Provider Type Created for Doula Services
Mar 31, 20222752Drug Use Review (DUR) Board Approves Changes Effective March 21, 2022
Mar 30, 20222751Attention Provider Type 86 (Specialized Foster Care): Update on Claims Denied with Error Code 4141
Mar 29, 20222750Attention All Providers: Delay in Processing Enrollments and Change/Update Requests
Mar 29, 20222749Attention Fee-for-Service Providers: Update Regarding Claims with Place of Service Codes 10 and 58
Mar 28, 20222748COVID-19 Vaccine Counseling Visits for Children under 21 Years of Age (Updated April 11, 2022, and December 5, 2022)
Mar 25, 20222747Attention All Providers: Reminder to Utilize the Electronic Verification System (EVS) to Verify Recipient Eligibility
Mar 23, 20222746Attention All Providers, Delegates and Staff: Upcoming Training Sessions for April 2022
Mar 22, 202227452022 Annual New Code Update
Mar 22, 20222744Claims Denied with Abortion Certificate Error Codes 3381 or 3382
Mar 21, 20222743Updates Regarding National Correct Coding Initiative (NCCI) Quarter 1 2022 Files
Mar 21, 20222742Rate Assigned for Office Visit Procedure Code 99417
Mar 18, 20222741Attention All Providers: Updated Notice on Neurotherapy Services for the Treatment of Mental Health Diagnoses and the Use of Biofeedback for the Treatment of Mental Health Diagnoses
Mar 17, 20222740COVID-19 UNWIND: Attention All Providers - Please Begin Recipient Outreach to Plan for End of the COVID-19 Public Health Emergency
Mar 17, 20222739Emergency Use Authorization Revoked for Monoclonal Antibody Injection and Infusion Codes
Mar 16, 20222738Inpatient Claims Denied in Error with Error Code 5001 Will Be Reprocessed
Mar 14, 20222737Professional and Outpatient Claims for Office Visit Procedure Code 99215
Mar 11, 20222736Attention All Providers: New Recipient/Enrollee Webpage Created Regarding Digital Medicaid ID Cards
Mar 11, 20222735Attention Provider Type 17 (Special Clinics) Specialty 182 (Indian Health Programs, Non-Tribal): COVID-19 Administration Codes Open for Billing
Mar 11, 20222734Prior Authorization for Non-Hospice Related Drugs for Recipients on Hospice
Mar 08, 20222733Update Regarding Claims for Procedure Codes with Duplicate Submissions
Mar 03, 20222732Attention All Providers, Delegates and Staff: Use Online Provider Enrollment Tool to Check Enrollment Application Status
Mar 02, 20222731Attention Home and Community Based Services (HCBS) Providers: Short-Term Supplemental Payments under American Rescue Plan Act (ARPA) Section 9817
Mar 02, 20222730Claims that Denied in Error with Error Code 5068 Have Been Reprocessed
Mar 02, 20222729Claims Denied or Paid in Error if Enrollment Contracts Overlapped with Other Providers Have Been Reprocessed
Mar 01, 20222728Attention Provider Type 68 (Intermediate Care Facilities for Individuals with Intellectual Disabilities / Private): Patient Liability to be Applied to Claims
Mar 01, 20222727Silver State Scripts Board (SSSB) Makes Changes to Preferred Drug List (PDL) Effective March 1, 2022
Feb 28, 20222726Attention All Providers, Delegates and Staff: Upcoming Training Sessions for March 2022
Feb 28, 20222725COVID-19 Billing Guides Updated
Feb 28, 20222724Attention Provider Type 12 (Hospital, Outpatient): Claims with National Drug Codes Processed Incorrectly and Denied in Error Have Been Reprocessed
Feb 25, 20222723Attention All Providers: Community Health Worker Provider Type Created
Feb 23, 20222722Attention Provider Type 12 (Hospital, Outpatient): Crisis Stabilization Center Specialty Created
Feb 22, 20222721Update: Medication-Assisted Treatment (MAT) Services with an Opioid Use Disorder (OUD) Diagnosis Must Be Billed with Modifier U5
Feb 22, 20222720Reminder to Bill Intrauterine Devices and Subdermal Implants with a National Drug Code (NDC) with a Unit of 1
Feb 22, 20222719Inpatient, Inpatient Crossover and Long Term Care Claim Reprocessing Update
Feb 18, 20222718Attention Provider Type 63 (Residential Treatment Center/Psychiatric Residential Treatment Center): Policy Clarification for Use of Psychiatric/Mental Health Advanced Practice Registered Nurse (APRN) Signatures
Feb 15, 20222717Hospital Presumptive Eligibility Annual Training Calendar Dates and Sign-up Guidelines for 2022
Feb 15, 20222716Attention Provider Types 24 (Advanced Practice Registered Nurses) and 56 (Inpatient Rehabilitation and Long Term Acute Care (LTAC) Specialty Hospitals): Update on Claims Denied with Error Code 5005
Feb 15, 20222715Claims for Some Electroencephalogram (EEG) Codes That Denied Have Been Reprocessed
Feb 15, 20222714Attention Provider Types 20 (Physician, M.D., Osteopath, D.O.), 24 (Advanced Practice Registered Nurse) and 77 (Physician Assistant): Claims for Cognitive Assessment and Care Planning Procedure Code 99483 Reprocessed
Feb 14, 20222713Attention Provider Type 12 (Hospital, Outpatient): Claims for Cognitive Assessment and Care Planning Procedure Code 99483 Reprocessed
Feb 14, 20222712Attention Provider Type 12 (Hospital, Outpatient): Some Physician-Administered Drug (PAD) Claims with Reject Code 70 Reprocessed
Feb 14, 20222711Update Regarding Inpatient and Outpatient Crossover Claims Impacted by Payment Error
Feb 14, 20222710Attention Provider Types 22 (Dentist) and 33 (Durable Medical Equipment, Prosthetics, Orthotics and Supplies): Claims with Error Code 5578 Reprocessed (Updated February 28, 2022)
Feb 10, 20222709Medicaid Management Information System Updated with NCCI Quarter 1 2022 Files
Feb 08, 20222708Attention Provider Type 22 (Dentist): Claims for Dental Procedure Code D1354
Feb 08, 20222707Attention Provider Type 28 (Pharmacy): IN-HOME COVID-19 Vaccine Administration Provider Incentive Adjusted
Feb 08, 20222706Attention Provider Type 28 (Pharmacy): COVID-19 Vaccine Administration Provider Incentive Fee Adjusted
Feb 08, 20222705Attention Provider Type 28 (Pharmacy): Expanded Use for the Pfizer BioNTech COVID-19 Vaccine
Feb 07, 20222704Smoking/Tobacco Cessation Counseling Procedure Codes 99406 and 99407 No Longer Restricted to Pregnant Women Only
Feb 07, 20222703Professional and Institutional Claims Denied in Error with Error Code 7201 Have Been Reprocessed
Feb 03, 20222702Attention All Providers: Reminder Regarding Training Options
Feb 01, 20222701Attention Personal Care Services and Adult Day Health Care Services Providers: Nevada’s Dual Eligible Special Needs Plans (D-SNP) Program Does Not Impact Recipient Eligibility
Feb 01, 20222700Attention Provider Type 68 (Intermediate Care Facilities for Individuals with Intellectual Disabilities / Private): Patient Liability to be Applied to Claims
Jan 31, 20222699Attention Provider Types 12 (Hospital, Outpatient) and 43 (Laboratory, Pathology Clinical): Laboratory Procedure Codes 81513 and 87563 Open for Billing
Jan 31, 20222698Attention Provider Type 86 (Specialized Foster Care): Claims for Recipients Enrolled in Both Nevada Medicaid Fee-For-Service (MCD) and Medicaid Fee-for-Service Child Welfare (MCDC)
Jan 31, 20222697Attention All Providers: Community Health Worker Provider Type Created
Jan 31, 20222696Attention Provider Type 22 (Dentist): Dental Claims for Recipients with Dental Managed Care that Paid in Error Have Been Reprocessed
Jan 28, 20222695Attention Provider Type 28 (Pharmacy): Nevada Medicaid Fee-for-Service (FFS) Update Regarding COVID-19 Oral Antivirals Reimbursement
Jan 27, 20222694Attention Provider Type 63 (Residential Treatment Center): Reminder Regarding Residential Treatment Center (RTC)/Psychiatric Residential Treatment Facility (PRTF) Critical Incident/Serious Occurrence Reporting Requirements
Jan 27, 20222693Attention All Providers: Refer to Electronic Verification System (EVS) User Manual to Assist with Navigating EVS
Jan 26, 20222692Attention All Providers, Delegates and Staff: Upcoming Training Sessions for February 2022
Jan 26, 20222691Attention All Providers: Reminder to Review Provider Type Specific Billing Guides
Jan 25, 20222690Online Form for Hospital and Physician Group Ownership; Senate Bill 329 Requires Reporting of Certain Business Arrangements (Updated January 28, 2022)
Jan 20, 20222689Attention Provider Type 28 (Pharmacy): Pfizer-BioNTech COVID-19 Vaccine for Individuals 16 and 17 Years of Age
Jan 20, 20222688Attention All Providers, Delegates and Staff: Automated Response System (ARS)
Jan 20, 20222687Attention Provider Type 20 (Physician, M.D., Osteopath, D.O.): Claims for Ultrasonic Guidance During Surgery Procedure Code 76998 Reprocessed
Jan 18, 20222686Attention All Providers: Janssen COVID-19 Booster Administration Code and Moderna Vaccine Booster and Administration Codes
Jan 18, 20222685Attention All Providers: Update on Claims Denied with Error Code 2504 When Other Insurance Applied to Co-Pay or Co-Insurance
Jan 14, 20222684Attention All Providers: Nevada Medicaid and Nevada Check Up District Office Call Center Hours Extended to Assist Recipients (Updated January 20, 2022)
Jan 14, 20222683Attention All Providers: Notify Medicaid Recipients to Act Immediately if They Wish to Switch MCO Plans (Updated January 20, 2022)
Jan 14, 20222682Attention Provider Type 28 (Pharmacy): Camphotrex™ Gel Requires Prior Authorization Effective January 12, 2022
Jan 11, 20222681Attention All Providers: Effective Immediately Use New Email Addresses to Contact Nevada Medicaid Fiscal Agent
Jan 11, 20222680Attention Provider Types 19 (Nursing Facility) and 65 (Hospice, Long Term Care): State Fiscal Year 2022 Quarter 3 Rate Updates Implemented
Jan 10, 20222679Mobile Digital Medicaid Cards Coming January 21, 2022
Jan 07, 20222678Health Professional Shortage Areas (HPSAs) Health Care Provider Assessment/Survey
Jan 07, 20222677Attention Provider Type 22 (Dentist): Delivery Receipt Form Required with Claims for Dentures (Updated February 3, 2023)
Jan 06, 20222676URGENT: To Ensure Continuity of Care, Providers Should Not Cancel Services or Request Out of Pocket Payment from Recipients Who Were Assigned a New MCO as of January 1, 2022 (Updated January 20, 2022)
Jan 06, 202226751099-Misc. Forms for 2021 Tax Year to be Mailed to Providers by January 31, 2022
Jan 06, 20222674Attention All Providers, Delegates and Staff: Secure Correspondence Communication Tool
Jan 05, 20222673Rate Increase for Registered Behavior Technicians under Provider Type 85 (Applied Behavior Analysis) Approved by Centers for Medicare & Medicaid Services (Updated January 26, 2022)
Jan 05, 20222672Attention Provider Type 86 (Specialized Foster Care): Service Limitations Reminder
Jan 05, 20222671Claims Reprocessed for Monoclonal Antibody Injection Codes Q0244 and Q0247 and Infusion Codes M0243, M0245 and M0247
Jan 03, 20222670Silver State Scripts Board (SSSB) Makes Changes to Preferred Drug List (PDL) Effective January 3, 2022
Jan 03, 20222669Updated Medicare Part D Benefit Co-Pay for 2022
Jan 03, 20222668Attention Provider Type 14 (Behavioral Health Outpatient Treatment): Procedure Codes Removed That Providers Are Not Qualified to Bill
Jan 03, 20222667Attention Provider Types 60 (School Health Services) and 85 (Applied Behavior Analysis): Update Regarding Applied Behavior Analysis Procedure Codes (Updated November 17, 2022)
Jan 03, 20222666Attention Provider Types (PTs) 45 (End Stage Renal Disease (ESRD) Facility) and 81 (Hospital Based ESRD Provider): Rates for Dialysis Codes 90945 and 90999 Adjusted for 2022
Dec 30, 2021Volume 18 Issue 4Nevada Medicaid and Nevada Check Up News (Fourth Quarter 2021 Provider Newsletter)
Dec 30, 202126652021 Consolidated Appropriations Act (CAA) Adds Coverage Requirements for Medicaid Recipients Participating in Qualifying Clinical Trials
Dec 27, 20212664Attention Provider Type 19 (Nursing Facility): Update Regarding Claims Impacted by State Fiscal Year 2022 Quarter 1 Rate Updates
Dec 21, 20212663Attention All Providers, Delegates and Staff: Reminder of Available Self-Service Options
Dec 21, 20212662Attention All Providers, Delegates and Staff: Upcoming Training Sessions for January 2022
Dec 20, 20212661Attention All Providers: COVID-19 Booster Vaccine Administration Code 0004A
Dec 20, 20212660Attention Provider Types 19 (Nursing Facility) and 65 (Hospice, Long Term Care): State Fiscal Year 2022 Quarter 2 Rate Updates Implemented
Dec 17, 20212659All Providers and Staff Invited to Take Women’s Preventive Services Initiative Awareness Survey by January 7, 2022
Dec 17, 20212658Attention All Providers: Recipient/Enrollee Webpage Created with Managed Care Organization (MCO) Expansion Information
Dec 16, 20212657Attention All Providers: 2022 Managed Care Caseload Distribution Notice (Updated January 20, 2022)
Dec 16, 202126562022 Annual New Code Update
Dec 15, 20212655Attention All Providers: Recipients May Request to Change Managed Care Organization (MCO) Plans (Updated January 20, 2022)
Dec 14, 20212654Attention Provider Type 28 (Pharmacy): In-Home COVID-19 Vaccination Administration (Updated December 28, 2021)
Dec 14, 20212653Attention Provider Type 58 (Home and Community Based Waiver for Persons with Physical Disabilities): Update Regarding Rate Restoration
Dec 14, 20212652Attention Behavioral Health Services Providers: Psychosocial Rehabilitation and Basic Skills Training Are Not Reimbursable on Same Date of Service as Intensive In-Home Supports and Services Provided through Specialized Foster Care Services
Dec 10, 20212651Attention Provider Type 86 (Specialized Foster Care): Include Modifier U8 on Initial Claim when Attaching Eligibility Checklist
Dec 10, 20212650Attention Provider Type 17 (Special Clinics) Specialties 171 (Methadone Clinic) and 215 (Substance Abuse Agency Model): Guidance Regarding DEA Final Rule for Mobile Methadone Units
Dec 09, 20212649Attention Provider Type 17 (Special Clinics) Specialty 188 (Certified Community Behavioral Health Centers): Requirement to Enroll with Managed Care Organizations for 2022 (Updated January 20, 2022)
Dec 08, 20212648Attention Provider Type 20 (Physician, M.D., Osteopath, D.O.): Update Regarding Metabolic Treatment Program through Nevada Early Intervention Services (NEIS)
Dec 08, 20212647Update Regarding Rates for Dialysis Codes 90945 and 90999 Adjusted for 2021
Dec 08, 20212646Attention Provider Type 17 (Special Clinics) Specialty 188 (Certified Community Behavioral Health Center): Medication-Assisted Treatment (MAT) for Opioid Use Disorder (OUD) Services May Be Billed
Dec 07, 20212645Attention Provider Type 32 Specialty 932 (Ambulance, Air or Ground): Billing Guide Has Been Updated with Modifier Billing Requirements
Dec 06, 20212644Attention Provider Type 33 (Durable Medical Equipment, Prosthetics, Orthotics and Supplies): Claims for Procedure Code S1040 Must Include Invoice
Dec 03, 20212643Attention Provider Types 60 (School Health Services) and 85 (Applied Behavior Analysis): Training Scheduled for December 13, 2021
Dec 03, 20212642Attention Provider Type 28 (Pharmacy): Folite Requires Prior Authorization Effective December 1, 2021
Dec 03, 20212641Attention Provider Type 28 (Pharmacy): FDA Expands Eligibility for COVID-19 Vaccine Boosters
Dec 01, 20212640Seriously Mental Ill (SMI) Adults or Recipients in Residential Treatment Centers (RTCs) to be Enrolled in Managed Care
Nov 24, 20212639Claims for Chemotherapy and Administration Related Codes Denied in Error
Nov 23, 20212638Some Behavioral Health Claims Denied in Error if Recipient Was Covered by Medicare
Nov 22, 20212637Attention All Providers: Please Distribute Flyer Regarding Managed Care Organization Changes
Nov 22, 20212636Professional and Outpatient Claims for Procedure Code 96375
Nov 19, 20212635Attention All Providers: 2022 Managed Care Caseload Distribution Notice (Updated January 20, 2022)
Nov 19, 20212634Medicaid Services Manual Chapters Updated
Nov 18, 20212633Attention Provider Type 28 (Pharmacy): COVID-19 Pfizer, Moderna and Janssen Booster Dose
Nov 17, 20212632Attention Provider Type 28 (Pharmacy): Emergency Use Authorization for Pfizer-BioNTech COVID-19 Vaccine for Children 5 through 11 Years of Age
Nov 15, 20212631Monoclonal Antibody Infusion Code M0240 Approved for Treatment of COVID-19 Infection (Updated December 28, 2021)
Nov 08, 20212630Attention Provider Type 64 (Hospice): Federal Fiscal Year (FFY) 2022 Annual Rates Update
Nov 03, 20212629Attention Provider Type 33 (Durable Medical Equipment, Prosthetics, Orthotics and Supplies): Durable Medical Equipment (DME) Prior Authorization Forms (Updated December 30, 2022, and February 17, 2023)
Nov 03, 20212628Update Regarding Inactive Delegate Accounts on the Provider Web Portal: Delegate Must Log In to Account the Same Day They are Activated
Nov 02, 20212627Attention Home and Community Based Waiver for Frail Elderly Providers: Update Regarding Rate Restorations
Nov 02, 20212626Attention Provider Type 22 (Dentist): Update Regarding Claims for Dental Code D0230
Nov 01, 20212625Drug Use Review (DUR) Board Approves Changes Effective November 1, 2021
Nov 01, 20212624Silver State Scripts Board (SSSB) Approves Changes to Preferred Drug List (PDL) Effective November 1, 2021
Nov 01, 20212623New Provider Orientation Scheduled for December 2021
Oct 28, 20212622Attention All Providers: Please Participate in Health Information Technology (HIT) Survey by November 29, 2021 (Updated November 10, 2021)
Oct 27, 20212621Current DHCFP Rate Review Survey Deadline Extended to November 30, 2021
Oct 27, 20212620Update Regarding Claims for Procedure Codes with Duplicate Submissions (Updated March 8, 2022)
Oct 25, 20212619Attention Provider Type (PT) 19 Nursing Facilities: Delay in Quarterly Behaviorally Complex Care Program (BCCP) Authorizations for SFY 2022 Q2 (Updated January 6, 2022)
Oct 25, 2021Volume 18 Issue 3 v2Nevada Medicaid and Nevada Check Up News (Third Quarter 2021 Provider Newsletter) (New Content Added)
Oct 25, 20212618COVID-19 Billing Guides Updated
Oct 25, 20212617Professional Claims Denied with Error Code 5040 Have Been Reprocessed
Oct 21, 20212616Attention All Providers: 2022 Managed Care Caseload Distribution Notice (Updated January 20, 2022)
Oct 20, 20212615Attention Provider Type 60 (School Health Services): Billing Guide Updated
Oct 19, 20212614Follow-up to Web Announcement 2583: Additional Prior Authorization Instructions Regarding Emergency Medicaid Only (EMO) Claims Related to COVID-19 Treatment
Oct 18, 20212613COVID-19 Related Hospital Transfers
Oct 18, 20212612Attention All Providers: COVID-19 Home Vaccine Administration Code and Administration Codes for Third Dose of Vaccine (Updated February 28, 2022)
Oct 18, 20212611Attention Provider Type 12 (Hospital, Outpatient): Cognitive Assessment and Care Planning Procedure Code 99483 May Be Billed (Updated February 11, 2022)
Oct 18, 20212610Attention Provider Type 17 Specialty 180 (Rural Health Clinics): DATA 2000 Waiver Training Payments Still Available for Rural Health Clinics
Oct 18, 20212609Gender Restrictions Updated for Certain ICD-10 Diagnosis Codes and Procedure Code 58300 (Updated June 3, 2022)
Oct 18, 20212608Inpatient and Outpatient Crossover Claims Impacted by Payment Error
Oct 15, 20212607Attention All Providers: DHCFP Fee-For-Service (FFS) Fee Schedule Update
Oct 15, 20212606Crossover Claims and Claims with Other Insurance that Denied with Error Code 676 Have Been Reprocessed
Oct 15, 202126052021 Dental Codes Denied with Error Code 4801 Have Been Reprocessed
Oct 15, 20212604Attention Provider Type 33 (Durable Medical Equipment, Prosthetics, Orthotics and Supplies): Claims for Some Wheelchair Procedure Codes Reprocessed
Oct 13, 20212603Attention Provider Types (PT) 19 Nursing Facilities and 65 (Hospice, Long Term Care) ONLY: Temporary Delay in Quarterly Nursing Facility Rate Updates and PT 19 Supplemental Payments for SFY 2022 Q2
Oct 13, 20212602Medicaid Management Information System Updated with NCCI Quarter 4 2021 Files
Oct 11, 20212601Update: Reprocessing of Claims for Procedure Code H2011 (Crisis Intervention Services) Completed
Oct 11, 20212600Medicaid Services Manual Chapter 1200 (Prescribed Drugs) and Chapter 3700 (Applied Behavior Analysis) Updated
Oct 11, 2021Volume 18 Issue 3Nevada Medicaid and Nevada Check Up News (Third Quarter 2021 Provider Newsletter) (New Content Added)
Oct 08, 20212599Medicare Crossover Claims that Denied Incorrectly for Timely Filing Have Been Reprocessed
Oct 08, 20212598Attention Provider Type 33 (Durable Medical Equipment, Prosthetics, Orthotics and Supplies): Update Regarding Claims Denied with Error Code 4257
Oct 07, 20212597Attention Provider Type 63 (Residential Treatment Center/Psychiatric Residential Treatment Center): Residential Treatment Center Concurrent Review Form Updated
Oct 07, 20212596All Applied Behavior Analysis Linkage – Provider Type 85
Oct 04, 20212595Attention Provider Type 22 (Dentist): Rate for Dental Code D2928 Corrected
Oct 01, 20212594Current DHCFP Rate Review Survey Deadline Extended to October 29, 2021
Sep 24, 20212593New Provider Orientation Scheduled for November 2021
Sep 24, 20212592Update Regarding Claims for Dialysis Codes 90945 and 90999 with Dates of Service in 2020
Sep 23, 20212591Transplant Maximum Reimbursement Rates Updated
Sep 23, 20212590Medication-Assisted Treatment (MAT) Services with an Opioid Use Disorder (OUD) Diagnosis Must Be Billed with Modifier U5
Sep 22, 20212589Additional Provider Relief Fund Payments to Be Available Due to COVID-19 Pandemic
Sep 20, 20212588Search Fee Schedule Tool Enhanced to Improve Provider Experience
Sep 20, 20212587Attention Provider Type 28 (Pharmacy): Reimbursement for Additional Doses of Moderna and Pfizer COVID-19 Vaccines
Sep 20, 20212586Attention Inpatient Hospitals and Facilities: Enter Value Codes and Number of Days on Claims
Sep 17, 20212585Annual Rate Adjustment for Provider Type 17 (Special Clinics), Specialty 180 (Rural Health Clinics)
Sep 17, 20212584Attention Provider Type 33 (Durable Medical Equipment, Prosthetics, Orthotics and Supplies): Medical Necessity Clarification for Non-Invasive Ventilators
Sep 17, 20212583Prior Authorization Requirements No Longer Bypassed for Emergency Medicaid Only (EMO) Claims Related to COVID-19 Treatment
Sep 16, 202125822022 Annual ICD-10-CM Diagnosis Code and ICD-10-PCS Inpatient Procedure Code Updates
Sep 15, 20212581Attention Provider Types 20 (Physician, M.D., Osteopath, D.O.), 24 (Advanced Practice Registered Nurse) and 77 (Physician’s Assistant): Updates to Procedure Codes 50382, 50384, 61615, Q4020 and 87493
Sep 14, 20212580Reminder: Do Not Bill Procedure Codes H0004, H2011 and H2014 with Duplicate Details
Sep 10, 20212579Update on the Urgent Announcement Regarding Claims Suspending for Budget Relief (Suspension Removed)
Sep 08, 20212578Urgent Announcement Regarding Claims Suspending for Budget Relief (Updated September 9, 2021)
Sep 07, 20212577Attention Provider Type 28 (Pharmacy): Guidance on Pharmacies Filling Prescriptions Under Declaration of Emergency Due to Caldor Fire
Sep 03, 20212576Attention Provider Type 60 (School Health Services): Some Health Behavior Assessment/Intervention Codes and Dental Codes May Be Billed
Sep 01, 20212575Nevada Medicaid Expands Dates for 2021-2022 Respiratory Syncytial Virus (RSV) Season
Aug 31, 20212574Drug Use Review (DUR) Board Approves Changes Effective September 1, 2021
Aug 31, 20212573New Provider Orientation Scheduled for October 2021
Aug 26, 20212572Reminder to Providers to Complete DHCFP Rate Review Surveys
Aug 25, 20212571U.S. Food and Drug Administration Approves First COVID-19 Vaccine
Aug 25, 20212570Chromosomal Microarray Analysis Procedure Codes 81228 and 81229 May Be Billed (Updated November 10, 2021)
Aug 25, 20212569Attention Provider Type 19 (Nursing Facility): State Fiscal Year 2022 Quarter 1 Rate Updates Implemented
Aug 23, 20212568Attention Provider Types 30 (Personal Care Services - Provider Agency) and 83 (Personal Care Services - Intermediary Service Organization): Personal Care Services (PCS) Prior Authorization Form Updated
Aug 23, 20212567Attention All Providers, Delegates and Staff: Upcoming Training Sessions for September 2021
Aug 20, 20212566Attention Provider Type 28 (Pharmacy): Amendment to Vaccine Administration Reimbursement for Additional Doses of Moderna and Pfizer COVID-19 Vaccines
Aug 18, 20212565Attention Provider Type 33 (Durable Medical Equipment, Prosthetics, Orthotics and Supplies): Cochlear Codes to be Open for Billing
Aug 16, 20212564Reprocessing of Claims for Procedure Code H2011 (Crisis Intervention Services) Scheduled to Begin
Aug 16, 20212563Attention Provider Type 58 (Home and Community Based Waiver for Persons with Physical Disabilities): Update Regarding Rate Restorations
Aug 16, 20212562Attention Home and Community Based Waiver for Frail Elderly Providers: Update Regarding Rate Restorations
Aug 16, 20212561Some Zero Rate Procedure Codes Will Be Assigned Rates
Aug 16, 20212560Attention Provider Types 19 (Nursing Facility) and 65 (Hospice, Long Term Care): State Fiscal Year 2021 Quarter 4 Rate Updates Implemented and Impacted Claims Reprocessed
Aug 13, 20212559Provider Billing Guidance for Synagis® (Palivizumab) (Updated September 1, 2021)
Aug 13, 20212558Attention Behavioral Health Providers Delivering Crisis Intervention (CI) Services: Prior Authorization Requirements for Emergency Requests
Aug 10, 20212557Attention Provider Type 33 (Durable Medical Equipment, Prosthetics, Orthotics and Supplies): Provider Training Sessions Scheduled
Aug 06, 20212556Providers Invited to Complete DHCFP Rate Review Surveys
Aug 05, 20212555Attention Provider Types 20 (Physician, M.D., Osteopath, D.O.), 24 (Advanced Practice Registered Nurse) and 77 (Physician’s Assistant): Ultrasonic Guidance During Surgery Procedure Code 76998
Aug 05, 20212554Attention Provider Types 20 (Physician, M.D., Osteopath, D.O.), 24 (Advanced Practice Registered