MedicaidPrior AuthMedium impact
Attention All Providers: Gender Criteria for Prior Authorization Now Available in the Provider Web Portal
Nevada Medicaid·NV·Prior Authorization
Effective date
Oct 20, 2025
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has updated their Provider Web Portal to include new Gender and Transgender Indicator columns for prior authorization criteria. Effective October 20, 2025, certain procedures will require prior authorization when a member's registered gender does not align with the procedure being performed.
Action Required
Immediately: Billing and authorization staff must access the updated Provider Web Portal and review the new Gender and Transgender Indicator columns when checking prior authorization requirements. Staff should verify gender alignment for procedures and obtain prior authorization when the member's registered gender does not match the procedure. Update workflow to include gender criteria review before submitting authorization requests.