How to become a Medicaid provider in Nevada
To bill Nevada Medicaid, enroll through Provider Flex (new enrollments, re-enrollments, ownership changes); Provider Web Portal (revalidations and updates), run by Gainwell Technologies. The process has 6 steps, listed below with the documents the state asks for.
- Enrollment portal
- Provider Flex (new enrollments, re-enrollments, ownership changes); Provider Web Portal (revalidations and updates)
- Steps
- 6
- Documents
- 9
- Plans listed
- 6
On this page
Nevada Medicaid enrollment at a glance
To bill Nevada Medicaid, enroll through Provider Flex (new enrollments, re-enrollments, ownership changes); Provider Web Portal (revalidations and updates), run by Gainwell Technologies. The process has 6 steps, listed below with the documents the state asks for.
- Program
- Nevada Medicaid and Nevada Check Up (Nevada Health Authority)
- Enrollment portal
- Provider Flex (new enrollments, re-enrollments, ownership changes); Provider Web Portal (revalidations and updates)
- Fiscal agent
- Gainwell Technologies
- Application fee
- Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts. Nevada's enrollment page and booklet do not list a separate state fee.
- Fingerprinting
- Provider types 19, 29, 33, 58 (specialty 205), 63, 64, 65 and 93 (specialty 708) must send a signed Nevada Department of Public Safety fingerprint background waiver for each owner holding 5% or more, because those owners may need a fingerprint-based criminal background check under 42 CFR 455.434. Under federal rules (42 CFR 455.434 and 455.450), the state places provider types in 'limited', 'moderate' or 'high' risk levels. High-risk providers, and anyone who owns 5% or more of one, must submit fingerprints for a criminal background check.
- Site visit
- Under federal rule (42 CFR 455.432), the state must visit moderate- and high-risk providers before and after enrollment. Every enrolled provider must allow unannounced on-site inspections. Nevada's enrollment booklet does not describe a separate state site visit process.
- Revalidation
- At least every 5 years; DMEPOS providers (provider type 33) every 3 years. Notices go out 120, 90, 60 and 20 days before the due date. A provider can revalidate up to one year early through the Provider Web Portal ('Revalidate-Update Provider'). The application must be approved before the due date, or the contract ends and the provider cannot serve fee-for-service or MCO members. Nevada also runs an accelerated revalidation of high-risk providers (Web Announcement 3935).
- Provider manual
- Provider manual
Steps
- Get an NPI and check the enrollment checklist for your provider type
- Start the application in Provider Flex. Paper applications are not accepted
- Upload the documents on your checklist, including license, FEIN proof and a voided check or bank letter for EFT
- E-sign through DocuSign. The signer uploads a state-issued ID (front and back) and records a liveness video
- Gainwell and Nevada Medicaid screen the application; report any later changes within 30 days
- To serve managed care members, complete centralized credentialing with the state CVO (Verisys), using CAQH for individual practitioners, then contract with each MCO
Documents the state asks for
Joining managed-care plan networks
- Credentialing
- Centralized credentialing: yes. Since February 28, 2025, every Nevada Medicaid managed care entity must use one state-contracted credentialing verification organization (Verisys) for primary source verification, instead of each plan credentialing separately. Individual practitioners need a CAQH application; the CVO contacts facilities directly. Fee-for-service enrollment through Gainwell is a separate step, and contracting is still with each plan. Statewide managed care, including rural areas, started January 1, 2026.
- Plans (state list)
- Anthem Blue Cross and Blue Shield Healthcare Solutions
- CareSource
- Health Plan of Nevada
- Molina Healthcare of Nevada, Inc.
- SilverSummit Healthplan
- LIBERTY Dental Plan of Nevada (Dental Benefits Administrator)
Frequently asked questions
How do I become a Medicaid provider in Nevada?
To bill Nevada Medicaid, enroll through Provider Flex (new enrollments, re-enrollments, ownership changes); Provider Web Portal (revalidations and updates), run by Gainwell Technologies. The process has 6 steps, listed below with the documents the state asks for.
Is there an application fee to enroll in Nevada Medicaid?
Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts. Nevada's enrollment page and booklet do not list a separate state fee.
How often must Nevada Medicaid providers revalidate?
At least every 5 years; DMEPOS providers (provider type 33) every 3 years. Notices go out 120, 90, 60 and 20 days before the due date. A provider can revalidate up to one year early through the Provider Web Portal ('Revalidate-Update Provider'). The application must be approved before the due date, or the contract ends and the provider cannot serve fee-for-service or MCO members. Nevada also runs an accelerated revalidation of high-risk providers (Web Announcement 3935).