What types of policy changes does Nevada Medicaid issue?

Nevada Medicaid regularly publishes coverage updates including prior authorization requirement changes, billing code additions or deletions, plan-type coverage modifications, and clinical policy revisions. PolicyChanges.app monitors these notices and summarizes the impact for providers.

How often does Nevada Medicaid update its policies?

Nevada Medicaid typically releases policy bulletins on a rolling basis throughout the year. Our system checks for new updates daily and adds them to this feed as soon as they are identified.

How many Nevada Medicaid policy changes are tracked here?

This page currently tracks 50 documented Nevada Medicaid policy changes. New items are added as they are identified.

What should I do when Nevada Medicaid changes a prior authorization policy?

Review each change's effective date and action-required notes. Update your billing and clinical workflows before the effective date to avoid claim denials. Each policy detail page on PolicyChanges.app includes a plain-English summary and action items.

Nevada Medicaid Policy Changes 2026 | Prior Auth & Coverage Updates

Nevada Medicaid Policy Changes & Prior Auth Updates

We track 50 documented policy changes from Nevada Medicaid across NV. Each entry includes an AI-generated plain-English summary, effective date, affected billing codes, and a direct link to the original Nevada Medicaid notice. Use the related links below to narrow results by specialty or state, or sign up for a free daily alert to receive new Nevada Medicaid updates automatically.

High impact

Silver State Scripts Board Made Changes to the Preferred Drug List Effective November 1, 2025

Nevada Medicaid·Effective Nov 1, 2025

Nevada Medicaid's Silver State Scripts Board made extensive changes to their Preferred Drug List effective November 1, 2025, moving many brand-name medications to non-preferred status while promoting their generic equivalents to preferred status. Multiple drug classes were affected including anticonvulsants, antipsychotics, insulins, and various other therapeutic categories, with some products removed entirely due to discontinuation or loss of Medicaid rebate participation.

Attention Provider Type (PT) 82 (Behavioral Health Rehabilitative Treatment): Sunsetting Provider Type

Attention Provider Types 29 (Home Health Agency), 64 (Hospice) and 65 (Hospice, Long Term Care): Clarification of Telehealth Flexibilities

Quarter 3 2026 New Code Update

Quarter 3 2026 New Code Update

Medicaid Management Information System Updated with NCCI Quarter 3 2026 Files

Procurement Award Timeline

Attention Provider Type 47 (Indian Health Services and Tribal Clinics): Use Modifier SE for Claims for Non-American Indian/American Native Members

Prior Authorization (PA) Guidance for Provider Type 82 (Behavioral Health Rehabilitative Treatment) Transitioning to a New Provider Type

Attention Provider Type 22 (Dental): Endodontics Claims May Have Paid in Error

Update to FA-11 Behavioral Health Outpatient or Rehabilitative Authorization Request Form

Silver State Scripts Board Made Changes to the Preferred Drug List Effective May 1, 2026

Attention All Behavioral Health Providers and Behavioral Health Inpatient Providers: Clarification on Selecting “Not Applicable” for Assessment Information on Prior Authorization Requests

Medicaid Services Manual Chapter 1200 Updated

Attention Electronic Visit Verification (EVV) Providers: Updates Regarding EVV Claims Submissions

Medicaid Services Manual Chapters Updated

Attention Provider Type 20 (Physician, M.D., Osteopath, D.O.): Billing Instructions for Inpatient Hospital Care Including Critical Care

Attention Provider Types (PT) 14/300 (Behavioral Health Outpatient Treatment) and PT 82/300 (Behavioral Health Rehabilitative Treatment): Qualified Mental Health Professionals (QMHP) Will Be Limited To Clinical Interns Only

Silver State Scripts Board Made Changes to the Preferred Drug List Effective February 1, 2026

Statewide Managed Care Provider Support (Updated January 27, 2026)

Urgent Notification: Attention Electronic Data Interchange (EDI) Trading Partners: Secure File Transfer Protocol (SFTP) Migration Required by January 20, 2026; Services Will Discontinue Starting January 21, 2026

Attention All Nursing Facilities: Ventilator Dependent Level of Care (LOC) Authorizations Will Be Limited to 180 Days from the Date the LOC was Approved

Attention All Providers: Top Claim Denial Reasons and Resolutions/Workarounds for December 2025 Professional Claims

Prior Authorization Updated in the Medicaid Management Information System for Neuropsychological, Psychological, and Developmental Testing Codes and Billing Guides Updated

Drug Use Review (DUR) Board approves changes for Physician Administered Drugs (PAD)

Attention Provider Type 17 (Special Clinics) Specialty 181 (Federally Qualified Health Center): Shadowing Billing Requirements Coming Soon (Updated November 19, 2025)

Attention Provider Type (PT) 82 (Behavioral Health Rehabilitative Treatment): Sunsetting Provider Type

Reminder for Provider Type 17 (Special Clinics) Specialty 181 (Federally Qualified Health Center): New Shadow Billing Requirements to be Implemented in January 2026

2026 Annual New Code Update

Attention Provider Type 17 (Special Clinics) Specialty 181 (Federally Qualified Health Center): New Shadow Billing Requirements Effective January 1, 2026

2026 Annual New Code Update

Attention Nevada Medicaid Providers Who Prescribe, Dispense, Or Administer Drugs: Nevada Medicaid has transitioned to a Single Preferred Drug List (sPDL)

Attention Provider Types 20 (Physician, M.D., Osteopath, D.O.), 24 (Advanced Practice Registered Nurse), 27 (Radiology and Non-Invasive Diagnostic Centers), and 77 (Physician’s Assistant): Updates to Radiation Therapy Codes

Attention Providers Submitting Prior Authorization (PA) with a Behavioral Health Process Type: Workaround for Submitting PA Without Assessment Scores

Attention All Behavioral Health Providers: Assessment Type Names for Behavioral Health Prior Authorizations (PA)

Attention All Providers: Top Claim Denial Reasons and Resolutions/Workarounds for November 2025 Professional Claims

Attention All Providers: The Legacy Online Enrollment Tool is Permanently Closing

Attention All Providers: Top 10 Claim Denial Reasons and Resolutions/Workarounds for October 2025 Professional Claims

Silver State Scripts Board Made Changes to the Preferred Drug List Effective November 1, 2025

Attention All Providers: Top 10 Claim Denial Reasons and Resolutions/Workarounds for September 2025 Professional Claims

ATTENTION Provider Type 19 (Nursing Facility): Update to Behaviorally Complex Care Program (BCCP) Processes

Attention Providers: New Nevada Medicaid Enrollment Requirements for Individuals Participating with Managed Care Entities

H.R.1 Section 71113: Prohibited Entities

Attention Provider Types 11 (Hospital, Inpatient) and 13 (Psychiatric Hospital, Inpatient): Critical Incident/Serious Occurrence Reporting Requirements

Attention Provider Type 22 (Dentist): Service Limitations Updated for Various Procedure Codes

Attention Hospice Provider Types 64 (Hospice) and 65 (Hospice, Long Term Care): Reminder Regarding Requirements for the Hospice Program Election Notice, Forms FA-92 and FA-93

Attention All Providers: Error Received When Creating Prior Authorization and Workaround

Drug Use Review (DUR) Board approves changes for Physician Administered Drugs (PAD)

Silver State Scripts Board Made Changes to the Preferred Drug List Effective August 1, 2025

Attention All Providers: Forms Updated Per Medical Record Documentation Policy

Attention All Providers: Enrollment Application Will Only Be Accepted Through the Provider Flex Enrollment Tool