We have approximately 48,500 Nevada Medicaid providers and facilities as of May 2025.
If you are a medical provider interested in serving Medicaid recipients, visit: Nevada Medicaid Website Provider Enrollment .
Nevada Medicaid's Provider Enrollment Unit oversees:
- Enrollment and Revalidations
- Contract terminations, suspensions. and/or educational notices
- Managed Care Entities Network Provider Collaboration
- Medicaid Services Manual Chapter 100 policy development & maintenance
- Hospital Presumptive Eligibility
- Provider Exclusion Verification
Centralized Credentialing
In February of 2025, Nevada Medicaid centralized the credentialing process for providers enrolling with the Managed Care Entities (MCE). Credentialing is the process by which a facility or individual provider or applicant is determined qualified to render services based on education, licensure, work history and other elements.
Centralized credentialing means that Nevada Medicaid's contracted Credentialing Verification Organization (CVO), facilitates provider credentialing activities for all MCEs; prior to centralizing this process providers were required to credential with each plan individually. Credentialing differs from enrollment which determines an applicant/provider meets the screening requirements for fee-for-service enrollment.
Enrollment activities are facilitated by Nevada Medicaid's contracted fiscal agent, Gainwell Technologies. Both enrollment and credentialing are governed by the Federal Code of Regulations (CFR), Nevada Medicaid Services Manual (MSM), contracted MCE policies, and the National Committee for Quality Assurance (NCQA) standards. Individual practitioners must have an application within The Council for Affordable Quality Healthcare Inc. (CAQH) database, the primary credentialing application portal, and facilities receive outreach from the CVO for application submission.
Provider Revalidations
Nevada Medicaid requires all providers to revalidate at least every 5 years, with the exception of those who provide Durable Medical Equipment, Prosthetics, Orthotics, and Disposable Medical Supplies (DMEPOS) who must revalidate every 3 years.
Providers can revalidate up to a year in advance of their revalidation due date. To avoid contract termination, providers are encouraged to submit a complete revalidation application online by logging into the Provider Web Portal.
For questions regarding enrollment applications, revalidations, billing, claims, training, etc., please contact Nevada Medicaid's fiscal agent at [ektdesignns_placeholder_ID0E1NAG].
For all other questions, call [ektdesignns_placeholder_ID0EEOAG] or email us at providerenrollment@dhcfp.nv.gov