PAYER READY CREDENTIALING & COMPLIANCE

State Guide

Credentialing in Nevada

Enrollment guides for 50 payers operating in Nevada.

What actually differs in Nevada

Credentialing advice written for "most states" tends to be wrong here in specific, expensive ways. These are the rules that only apply in Nevada.

5 sourced rules, each linked to its source
Behavioral health integrated into the MCOs

Nevada does not carve behavioral health out to a separate BHO or ASO, all health plans cover the same basic benefits including physical and behavioral health. After the 2026 statewide expansion, BH is predominantly MCO-delivered, with Gainwell FFS for the residual FFS population and the state public behavioral health system for state-operated services. A solo BH clinician credentials with the MCOs serving their county.

Nevada Medicaid enrollee/MCO information via kb/states/nv.md · checked Jul 2026

Managed care went STATEWIDE January 1, 2026 Nev. Rev. Stat. § 422.273

Nevada Medicaid managed care, historically urban-only (Clark and Washoe counties), expanded to all 17 counties on January 1, 2026 under NRS 422.273, moving about 75,000 rural members into MCOs while roughly 126,000 members remain fee-for-service. The five statewide MCOs: Anthem BCBS Healthcare Solutions, CareSource (the new fifth entrant), Health Plan of Nevada, Molina Healthcare of Nevada, and SilverSummit Healthplan. The implication for rural providers: FFS-only enrollment no longer reaches most members, credential with the MCOs serving your county.

DHCFP Statewide Managed Care Program via kb/states/nv.md · checked Jul 2026

Interns enroll as QMHPs inside an agency (Pattern C) NV MSM Ch. 400 § 403 (eff. 2026-04-29)

Nevada's master's-track interns (CSW Interns, LMFT and LCPC post-graduate interns) enroll in Medicaid themselves, provider type 14, specialty 300 (QMHP), but only inside an enrolled entity/agency/group, with reimbursement at the QMHP rate including clinical supervision by an independently licensed supervisor who assumes responsibility. Interns are excluded from functioning as clinical supervisors, and FA-11 authorizations need the clinical supervisor's signature alongside the intern's. The psychology track is the mirror image: psychological assistants, interns and trainees are supervisor-BILLED (Pattern B) and cannot ride the QMHP lane.

Nevada MSM Chapter 400 (current edition) via kb/states/nv.md · checked Jul 2026

Counseling Compact status + board naming NRS 641A; NRS 641B

Nevada is a Counseling Compact member (enacted 2025) but not yet issuing privileges as of July 2026. Note Nevada's naming: the LPC-equivalent is the CPC (Clinical Professional Counselor), licensed with MFTs on one board (NRS 641A); social workers license separately under NRS 641B.

counselingcompact.gov jurisdictions via kb/states/nv.md · checked Jul 2026

State controlled-substance registration (Board of Pharmacy) NRS 632.237

Nevada requires a State Board of Pharmacy controlled-substance registration on top of the DEA for physicians AND NPs/PAs. A separate prescribing gate that catches out-of-state groups. Nevada NPs otherwise have full practice authority including independent controlled-substance prescribing (NRS 632.237).

NV Board of Pharmacy CS registration via kb/states/nv.md · checked Jul 2026

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Who Runs Nevada Medicaid Provider Enrollment

50-state research

Enrollment Portal

Nevada Medicaid provider portal

Operated By

Gainwell Technologies

Platform

State MMIS

From PayerReady's 50-state Medicaid enrollment platform research, verified July 2026. Portal contracts change; where an operator is in transition or not publicly confirmed, we say so rather than guess.

Aetna

Aetna (CVS Health)

Commercial
Network: Open

Timeline: 90-150 days

CAQH Required

View Full Guide →

UnitedHealthcare

UnitedHealthcare

Commercial
Network: Open

Timeline: 45-90 days

CAQH Required

View Full Guide →

Cigna Healthcare

Cigna Healthcare

Commercial
Network: Open

Timeline: 45-60 days

CAQH Required

View Full Guide →

Anthem / Elevance Health

Anthem Blue Cross Blue Shield

Commercial
Network: Open

Timeline: 45-90 days

CAQH Required

View Full Guide →

Humana

Humana

Commercial
Network: Open

Timeline: 45-90 days

CAQH Required

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Centene Corporation

Centene

Commercial
Network: Open

Timeline: 60-90 days

CAQH Required

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Molina Healthcare

Molina Healthcare of Nevada

Commercial
Network: Open

Timeline: 60-90 days

CAQH Required

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Anthem Blue Cross and Blue Shield of Nevada

Blue Cross Blue Shield
Network: Open

Timeline: 45-60 days

CAQH Required

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Nevada Medicaid

Medicaid
Network: Open

Timeline: 30-60 days

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Molina Healthcare (Medicaid)

Molina Healthcare (Medicaid)

Managed Care Organization
Network: Open

Timeline: 30-60 days

CAQH Required

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TRICARE

TRICARE
Network: Open

Timeline: 30-90 days

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TRICARE West Region (TriWest Healthcare Alliance)

TRICARE
Network: Open

Timeline: 30-60 days

CAQH Required

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CHAMPVA

CHAMPVA (VA Office of Integrated Veteran Care)

CHAMPVA
Network: Open

Timeline: 14-45 days

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Delta Dental

Delta Dental

Dental
Network: Open

Timeline: 90-120 days

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Cigna Dental

Cigna Dental

Dental
Network: Open

Timeline: 45-90 days

CAQH Required

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MetLife Dental

MetLife Dental

Dental
Network: Open

Timeline: 60-120 days

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Guardian Dental

Guardian Dental

Dental
Network: Open

Timeline: 60-90 days

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Aetna Dental

Aetna Dental

Dental
Network: Open

Timeline: 60-120 days

CAQH Required

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United Concordia

United Concordia Dental

Dental
Network: Open

Timeline: 45-90 days

CAQH Required

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DentaQuest

DentaQuest (a Sun Life company)

Dental
Network: Open

Timeline: 30-60 days

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MCNA Dental

MCNA Dental

Dental
Network: Open

Timeline: 30-60 days

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Liberty Dental Plan

LIBERTY Dental Plan

Dental
Network: Open

Timeline: 10-90 days

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Dental Network of America

Dental
Network: Open

Timeline: 60-90 days

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VSP Vision Care

VSP Vision Care

Vision
Network: Open

Timeline: 30-60 days

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EyeMed Vision Care

EyeMed Vision Care

Vision
Network: Open

Timeline: 30-60 days

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Davis Vision

Davis Vision (Versant Health / MetLife)

Vision
Network: Open

Timeline: 30-60 days

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Spectera / UHC Vision

Spectera (UnitedHealthcare Vision)

Vision
Network: Open

Timeline: 30-60 days

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Optum Behavioral Health

Optum Behavioral Health (United Behavioral Health)

Behavioral Health
Network: Open

Timeline: 30-45 days

CAQH Required

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Carelon Behavioral Health

Carelon Behavioral Health (formerly Beacon Health Options)

Behavioral Health
Network: Open

Timeline: 30-60 days

CAQH Required

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Magellan Health

Magellan Behavioral Health

Behavioral Health
Network: Open

Timeline: 30-60 days

CAQH Required

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Evernorth Behavioral Health

Evernorth Behavioral Health (formerly Cigna Behavioral Health)

Behavioral Health
Network: Open

Timeline: 30-60 days

CAQH Required

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Friday Health Plans

Commercial
Network: Open

Timeline: 30-60 days

CAQH Required

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Alignment Healthcare

Commercial
Network: Open

Timeline: 30-60 days

CAQH Required

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Workers' Compensation

Workers' Compensation
Network: Open

Timeline: 14-60 days

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Noridian Healthcare Solutions (Jurisdiction E)

Medicare
Network: Open

Timeline: 60-90 days

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Noridian Healthcare Solutions (DME A/D)

Medicare_dme
Network: Open

Timeline: 60-120 days

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Ambetter

Ambetter (a Centene company)

Commercial
Network: Open

Timeline: 60-90 days

CAQH Required

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Amerigroup (Wellpoint)

Commercial
Network: Open

Timeline: 60-90 days

CAQH Required

View Full Guide →

Anthem Blue Shield

Commercial
Network: Open

Timeline: 60-90 days

CAQH Required

View Full Guide →

Blue Cross Blue Shield

Commercial
Network: Open

Timeline: 60-90 days

CAQH Required

View Full Guide →

Carelon

Commercial
Network: Open

Timeline: 60-90 days

CAQH Required

View Full Guide →

Centene Corporation

Wellcare (a Centene company)

Commercial
Network: Open

Timeline: 60-90 days

CAQH Required

View Full Guide →

Community Plan

Commercial
Network: Open

Timeline: 60-90 days

CAQH Required

View Full Guide →

Compsych

Behavioral Health
Network: Open

Timeline: 60-90 days

CAQH Required

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Medicaid

Government
Network: Open

Timeline: 60-90 days

CAQH Required

View Full Guide →

Medicare

Government
Network: Open

Timeline: 60-90 days

CAQH Required

View Full Guide →

Medicare Fee-for-Service (CMS)

Medicare
Network: Open

Timeline: 45-120 days

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Megellan

Magellan Behavioral Health

Behavioral Health
Network: Open

Timeline: 60-90 days

CAQH Required

View Full Guide →

MultiPlan

MultiPlan / Claritev (PHCS Network)

Commercial
Network: Open

Timeline: 60-90 days

CAQH Required

View Full Guide →

UnitedHealthcare Community Plan

Managed Care Organization
Network: Open

Timeline: 30-60 days

CAQH Required

View Full Guide →

Reviewed by the PayerReady Credentialing Team

Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.

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