MedicaidReimbursementHigh impact
Attention Provider Types 19 (Nursing Facility) and 65 (Hospice, Long Term Care): State Fiscal Year 2027 Quarter 1 Rate Updates Implemented
Nevada Medicaid·NV · Geriatrics, Palliative Care·Reimbursement
Effective date
Jul 1, 2026
We identified it
Aug 4, 2026
Summary
Nevada Medicaid implemented State Fiscal Year 2027 Quarter 1 rate updates for nursing facilities (Provider Type 19) and hospice/long-term care (Provider Type 65) effective July 1, 2026. Claims submitted with dates of service on or after July 1, 2026 that were paid at previous rates will be automatically reprocessed under the new rates, with results reported on future remittance advice. Reprocessed claims are subject to all system and clinical edits, which may result in additional payments, denials, or no change.
Action Required
By July 1, 2026: Billing team must ensure all claims for Provider Types 19 (Nursing Facility) and 65 (Hospice, Long Term Care) submitted on or after this date are billed using the new SFY 2027 Quarter 1 rates in the Nevada Medicaid Management Information System (MMIS). Monitoring required: Track remittance advices for reprocessed claims from July 1, 2026 forward to identify any denials or adjustments. Establish appeal process review: Ensure clinical and billing staff are prepared to address potential denials upon reprocessing, as all system and clinical edits will apply. Refer to Nevada Medicaid Services Manual Chapter 100 and Billing Manual for appeal procedures and timeframes. No action needed for claims with dates of service prior to July 1, 2026.