Provider Enrollment
Thank you for your interest in the Nevada Medicaid and Nevada Check Up Program. This page contains all of the information and forms you will need to become a Nevada Medicaid provider. If you have any questions, please contact the Provider Enrollment Unit at (877) 638-3472 from 8 a.m. to 5 p.m. Pacific Time Monday through Friday.
All providers are required to submit their provider enrollment or re-enrollment applications electronically. Paper applications are not accepted.
If you need to RESUME an application that was started in the Online Provider Enrollment (OPE) tool
The following provider types are LIVE in Provider Flex:
24 – Advanced Practice Registered Nurse
72 – Nurse Anesthetist
74 – Nurse Midwife
77 – Physician’s Assistant
for Provider Flex Enrollment resources
All other provider types have not yet been implemented in the Provider Flex Enrollment tool.
for Online Provider Enrollment (OPE) resources
CHANGE IS COMING!
We are excited to announce Provider Flex, our streamlined, intuitive, integrity-based provider enrollment solution. This exciting new tool will be available to all providers by mid- 2025.
Important Dates
| Group 1 | Group 2 | Group 3 | Group 4 | |
|---|---|---|---|---|
| Provider Types(PT) | 24 72 74 77 |
20 | 14 82 |
All Remaining Provider Types |
| Blackout | Week of April 14 | Week of May 5 | Week of June 9 | Week of June 30 |
| Provider Flex Availability | April 22 | May 13 | June 17 | July 8 |
| Training begins Week of April 7 | ||||
Provider Types
- 24 - Advanced Practice Registered Nurses
- 72 - Nurse Anesthetist
- 74 - Nurse Midwife
- 77 - Physician's Assistant
- 20 - Physician M.D., Osteopath, D.O.
- 14 - Behavioral Health Outpatient Treatment
- 82 - Behavioral Health Rehabilitative Treatment
Revalidation Report
- Provider Revalidation Report: The Nevada Medicaid Provider Revalidation Report lists each provider and the date their next revalidation is due. To avoid contract termination, your revalidation application must be processed and approved prior to the revalidation due date. Providers can start their revalidation process up to a year in advance. Revalidations submitted prior to one year in advance will be returned.
Hospital Presumptive Eligibility Documents
- Web Announcement 3306: Hospital Presumptive Eligibility Annual Training Calendar Dates and Sign-up Guidelines for 2024
- Web Announcement 1008: Attention ALL Hospital Presumptive Eligibility Providers: Guidance Policy Available
- Web Announcement 861 with Training Schedule: Implementation of Hospital Presumptive Eligibility Option for Acute Care Hospitals (Provider Types 11 and 75)
- Nevada Medicaid Hospital Presumptive Eligibility Provider Addendum: Qualified hospitals must complete and submit the Nevada Medicaid Hospital Presumptive Eligibility Provider Addendum.
- Hospital Presumptive Eligibility Training Sign-Up Sheet: Complete this form listing the hospital employees that will be attending the mandatory training for Presumptive Eligibility. You will be notified by the DWSS in regards to the training dates and times. Keep in mind that each employee making PE determinations MUST be trained by DWSS and complete a competency examination prior to making ANY determinations.
Pregnancy Presumptive Eligibility Documents
- Pregnancy Presumptive Eligibility Participation Guidelines and Billing Instructions: Pregnancy Presumptive Eligibility Participation Guidelines and Billing Instructions.
- Pregnancy Presumptive Eligibility Provider Addendum: Qualified providers must complete and submit the Nevada Medicaid Presumptive Eligibility Provider Addendum.
- Pregnancy Presumptive Eligibility Training Sign-Up Sheet: Complete this form listing the employees that will be attending the mandatory training for Pregnancy Presumptive Eligibility. You will be notified by the DWSS in regards to the training dates and times. Keep in mind that each employee making PE determinations MUST be trained by DWSS and complete a competency examination prior to making ANY determinations.
Changes to Provider Information
Changes to any information presented on your enrollment documents must be reported to Nevada Medicaid within five business days.
- To complete changes online, please login to the Secure Web Portal, and choose “Revalidate-Update Provider”.
- To report a change in business ownership, submit a completed Provider Enrollment Application.
Provider License Updates and Voluntary Terminations Only
- Please submit provider license updates via the secure Provider Web Portal or email to Nevada Medicaid at nv.providerapps@gainwelltechnologies.com for processing.
- Please email voluntary termination forms (FA-34) to Nevada Medicaid at nv.providerapps@gainwelltechnologies.com for processing.