MedicaidAdministrativeHigh impact
Medicaid Services Manual Chapters Updated
Nevada Medicaid·NV · Psychiatry, Family Medicine, Internal Medicine +2 more·Provider Announcement
Effective date
Feb 25, 2026
We identified it
Jun 21, 2026
Summary
Nevada Medicaid updated six chapters of their Services Manual with significant changes to mental health services, physician services, prescribed drugs, substance use disorder treatment, peer support services, and intellectual disability facilities. Key changes include revised reimbursement structures, updated prior authorization requirements, and new provider enrollment requirements for multiple locations.
Action Required
Before February 25, 2026: Nevada providers must review and implement multiple changes including: 1) Mental health providers must obtain separate NPIs for Coordinated Specialty Care teams and update assessment billing to allow 4 units per year before prior auth; 2) Physicians must review critical care billing policies for same-day E&M services in hospital settings; 3) Pharmacy teams must update prior authorization criteria for diabetic supplies and gastrointestinal medications; 4) Substance use disorder providers with multiple locations must enroll each site separately with unique NPIs and participate in centralized bed registry; 5) Update peer support service limitations to 52 hours/208 units annually before prior auth required. Review all six updated manual chapters and update billing systems accordingly.