MedicaidPrior AuthHigh impact
Attention Provider Types 11 (Hospital, Inpatient) and 13 (Psychiatric Hospital, Inpatient): Reminder of Non-Emergent Hospital or Level of Care Transfer Requirements
Nevada Medicaid·NV · Psychiatry, General Surgery, Emergency Medicine +1 more·Provider Announcement
Effective date
May 30, 2025
We identified it
Jun 21, 2026
Summary
Nevada Medicaid requires prior authorization for all non-emergent hospital-to-hospital transfers and level-of-care changes within hospitals. The transferring physician must request authorization before transfer, and receiving hospitals must confirm authorization is in place before accepting patients.
Action Required
Immediately: Hospital billing teams must establish workflow requiring prior authorization verification before accepting non-emergent transfers. Receiving hospitals must confirm approved authorization exists before admitting transferred patients. Transferring physicians must request authorization prior to any non-emergent hospital-to-hospital or level-of-care transfers. Update admission procedures to check PWP system for PAR status using recipient ID or PAR number.