Nevada Medicaid and Nevada Check Up News (Third Quarter 2024 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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Unwinding COVID-19 Information

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 September 2024 Professional Claims. See Web Announcement 3465.

Top Enrollment Return Reasons and Resolutions for January 2024 Submissions. See Web Announcement 3350.

Top Prior Authorization Denial Reasons for the Third Quarter of 2024. See Web Announcement 3488.

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.

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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

2016 P&T Pharmacy Meetings

Notice Date Title
December 2016 For Review at December 8, 2016, Meeting: Agents for Gout
December 2016 For Review at December 8, 2016, Meeting: Angiotensin-Converting Enzyme (ACE) Inhibitors Single Entity Agents
December 2016 For Review at December 8, 2016, Meeting: Immunomodulators
December 2016 For Review at December 8, 2016, Meeting: Opioid-Induced Constipation Agents
December 2016 For Review at December 8, 2016, Meeting: Oral Anticoagulants
December 2016 For Review at December 8, 2016, Meeting: Otic Fluoroquinolones
December 2016 For Review at December 8, 2016, Meeting: Sedative Hypnotics
December 2016 For Review at December 8, 2016, Meeting: Sodium-glucose Co-transporter 2 Inhibitors
September 2016 For Review at September 22, 2016, Meeting: Agents for Gout
September 2016 For Review at September 22, 2016, Meeting: Alzheimer’s Agents
September 2016 For Review at September 22, 2016, Meeting: Androgens (Testosterone)
September 2016 For Review at September 22, 2016, Meeting: Anticonvulsants
September 2016 For Review at September 22, 2016, Meeting: Attention Deficit/Hyperactivity Disorder (ADHD) Agents
September 2016 For Review at September 22, 2016, Meeting: Benign Prostatic Hyperplasia (BPH) Treatments
September 2016 For Review at September 22, 2016, Meeting: Calcium-Channel Blocking Agents (Dihydropyridines)
September 2016 For Review at September 22, 2016, Meeting: Dipeptidyl Peptidase-4 (DPP-4) Inhibitors
September 2016 For Review at September 22, 2016, Meeting: Fibric Acid Derivatives
September 2016 For Review at September 22, 2016, Meeting: Growth Hormone
September 2016 For Review at September 22, 2016, Meeting: Hepatitis C Antivirals and Combinations, Direct Acting
September 2016 For Review at September 22, 2016, Meeting: Immunomodulators
September 2016 For Review at September 22, 2016, Meeting: Incretin Mimetics
September 2016 For Review at September 22, 2016, Meeting: Inhaled Anticholinergics
September 2016 For Review at September 22, 2016, Meeting: Inhaled Corticosteroids
September 2016 For Review at September 22, 2016, Meeting: Injectable Anticoagulants
September 2016 For Review at September 22, 2016, Meeting: Insulins
September 2016 For Review at September 22, 2016, Meeting: Intranasal Corticosteroids
September 2016 For Review at September 22, 2016, Meeting: Long-Acting Inhaled B2-Agonists (Single Entity)
September 2016 For Review at September 22, 2016, Meeting: Long-acting Opioids
September 2016 For Review at September 22, 2016, Meeting: Meglitinides
September 2016 For Review at September 22, 2016, Meeting: Multiple Sclerosis Agents
September 2016 For Review at September 22, 2016, Meeting: Neurokinin-1 (NK1) Receptor Antagonists and Combinations
September 2016 For Review at September 22, 2016, Meeting: Niacin Derivatives
September 2016 For Review at September 22, 2016, Meeting: Ophthalmic Antihistamines
September 2016 For Review at September 22, 2016, Meeting: Ophthalmic Carbonic Anhydrase Inhibitors
September 2016 For Review at September 22, 2016, Meeting: Ophthalmic Fluoroquinolones
September 2016 For Review at September 22, 2016, Meeting: Ophthalmic Nonsteroidal Anti-Inflammatory Drugs
September 2016 For Review at September 22, 2016, Meeting: Ophthalmic Prostaglandin Analogues
September 2016 For Review at September 22, 2016, Meeting: Opioid Dependence Agents
September 2016 For Review at September 22, 2016, Meeting: Oral Atypical (Second-Generation) Antipsychotics
September 2016 For Review at September 22, 2016, Meeting: Phosphorus Depleters
September 2016 For Review at September 22, 2016, Meeting: Platelet Inhibitors
September 2016 For Review at September 22, 2016, Meeting: Proton Pump Inhibitors
September 2016 For Review at September 22, 2016, Meeting: Pulmonary Arterial Hypertension Agents
September 2016 For Review at September 22, 2016, Meeting: Respiratory Corticosteroid/Long-Acting B-Agonists Combinations
September 2016 For Review at September 22, 2016, Meeting: Scabicides and Pediculicides
September 2016 For Review at September 22, 2016, Meeting: Second and Third Generation Oral Fluoroquinolones
September 2016 For Review at September 22, 2016, Meeting: Selective Serotonin Reuptake Inhibitors
September 2016 For Review at September 22, 2016, Meeting: Short-acting B2-Agonists
September 2016 For Review at September 22, 2016, Meeting: Sodium-glucose co-transporter 2 (SGLT2) Inhibitors
September 2016 For Review at September 22, 2016, Meeting: Topical Antivirals
September 2016 For Review at September 22, 2016, Meeting: Topical Vitamin D Analogs and Combinations
September 2016 For Review at September 22, 2016, Meeting: Ulcerative Colitis Agents
March 2016 For Review at March 24, 2016, Meeting: Benzoyl Peroxide/Antibiotic Combinations
March 2016 For Review at March 24, 2016, Meeting: Extended-Release Injectable Atypical (Second-Generation) Antipsychotics
March 2016 For Review at March 24, 2016, Meeting: Inhaled Anticholinergics
March 2016 For Review at March 24, 2016, Meeting: Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
March 2016 For Review at March 24, 2016, Meeting: Ophthalmic Steroids