MedicaidReimbursementMedium impact
Attention Provider Type 12 (Hospital, Outpatient): Provider-Specific Rates Updated for Critical Access Hospitals (Updated October 3, 2024)
Nevada Medicaid·NV·Provider Enrollment
Effective date
Jan 1, 2024
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has implemented new provider-specific reimbursement rates for publicly owned Critical Access Hospitals (CAHs) under provider type 12, requiring payment at actual cost of services. Claims with service dates from January 1, 2024 onward will be automatically reprocessed to apply the correct rates.
Action Required
Immediately: Monitor upcoming remittance advice for automatically reprocessed CAH claims with dates of service January 1, 2024 and later. Review any new denials that may result from reprocessing and prepare appeals if necessary following Medicaid Services Manual Chapter 100 guidelines. This action applies only to publicly owned Critical Access Hospitals billing under provider type 12.