Nevada Medicaid and Nevada Check Up News (First Quarter 2026 Provider Newsletter) [Read]

Attention Behavioral Health Providers: Monthly Behavioral Health Training Assistance (BHTA) Webinar Scheduled [See Web Announcement 2009]

Attention All Providers: Requirements on When to Use the National Provider Identifier (NPI) of an Ordering, Prescribing or Referring (OPR) Provider on Claims [Announcement 850]

If you are a Medicaid provider whose revalidation application has not been processed by your termination due date, you will be ineligible to provide services to any Nevada Medicaid or Nevada Check Up recipients, including both Fee-for-Service and Managed Care Organization (MCO) enrolled recipients. See Web Announcement 1265

Enrollment Termination Frequently Asked Questions (FAQs) [Review]

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NOTIFICATION: The following Nevada Medicaid Provider Web Portal services will be unavailable from 8 p.m. Pacific Time on Monday, May 11, 2026, through 4 a.m. Pacific Time on Tuesday, May 12, 2026, for scheduled maintenance:
  • All secure Provider Web Portal (PWP) functions
  • Provider Flex
  • Gabby®, which includes:
    • Gainwell Technologies Contact Center (877) 638-3472
    • Automated Response System (ARS) (800) 942-6511
  • Real time CAQH/CORE EDI eligibility and claim verification
  • Provider Pre-Admission Screening Resident Review (PASRR)
    • Known System Issues-Click HERE

    Top 10 Claim Denial Reasons and Resolutions/Workarounds for March 2026 Professional Claims. See Web Announcement 3894.

    Top Prior Authorization Denial Reasons for the First Quarter of 2026. See Web Announcement 3900.

    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 https://NevadaMedicaid.nv.gov/ and the Billing Guide for your provider type at www.medicaid.nv.gov.

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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
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1. Known_Issues.pdf
... 2/6 /2019 2/13/2019 N/A Secure correspondence messages submitted on the the Admin/Provider user log-in and Correspondence Web Portal. ...
Terms matched: 1  -  Score: 78  -  06 May 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Known_Issues.pdf
2. DME_Enrollment_Moratorium_Exemption_Request.pdf
... • Be subject to a Fingerprint-Based Criminal Background Check (FCBC) and Site Visit. 5. APPLICANT ACKNOWLEDGMENT I have read and agree with the NVHA ...
Terms matched: 1  -  Score: 20  -  30 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/DME_Enrollment_Moratorium_Exemption_Request.pdf
3. NV_BillingGuidelines_PT60.pdf
... . Covered Services Medicaid covers the following services provided in a school or other community site: • Screening and diagnostic services • Physician services â ...
Terms matched: 1  -  Score: 155  -  29 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60.pdf
4. NV_BillingGuidelines_PT60_2025-1216.pdf
... . Covered Services Medicaid covers the following services provided in a school or other community site: • Screening and diagnostic services • Physician services â ...
Terms matched: 1  -  Score: 155  -  29 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT60_2025-1216.pdf
5. Provider_Enrollment_Information_Booklet.pdf
... (SAPTA) certificate/endorsement showing certified Levels of Care • Access Site attestation, if applicable Refer to the Certified Community Behavioral Health Center (CCBHC ...
Terms matched: 1  -  Score: 11  -  21 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/Provider_Enrollment_Information_Booklet.pdf
6. NV_BillingGuidelines_PT20-24-77.pdf
... threatened suicide); and • office or other outpatient visits. Originating site: Use procedure code Q3014. Distant site: Use the appropriate procedure code ...
Terms matched: 1  -  Score: 24  -  03 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT20-24-77.pdf
7. NV_BillingGuidelines_PT20-24-77_online_011226_to_040326.pdf
... threatened suicide); and • office or other outpatient visits. Originating site: Use procedure code Q3014. Distant site: Use the appropriate procedure code ...
Terms matched: 1  -  Score: 24  -  03 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT20-24-77_online_011226_to_040326.pdf
8. web_announcement_2858_20220729.pdf
... Intern enrolling with the approved licensure and the letter may only link to an approved site listed on the letter. The Intern shall not be linked to any other ...
Terms matched: 1  -  Score: 36  -  01 Apr 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/web_announcement_2858_20220729.pdf
9. NV_BillingGuidelines_PT22-attachmentA_01-29-26.pdf
... PER QUAD 00 NC NC 4 units per 60 months D4263 BONE REPLCE GRAFT FIRST SITE 00 NC NC 4 units per 60 months D4264 BONE REPLCE GRAFT EACH ADD ...
Terms matched: 1  -  Score: 12  -  23 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentA_01-29-26.pdf
10. NV_BillingGuidelines_PT22-attachmentA.pdf
... PER QUAD 00 NC NC 4 units per 60 months D4263 BONE REPLCE GRAFT FIRST SITE 00 NC NC 4 units per 60 months D4264 BONE REPLCE GRAFT EACH ADD ...
Terms matched: 1  -  Score: 12  -  23 Mar 2026  -  URL: https://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT22-attachmentA.pdf
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