Topics Related to Division of Health Benefits

Effective with date of service Aug. 1, 2025, NC Medicaid covers benzathine benzylpenicillin (Extencilline®) and benzathine benzylpenicillin tetrahydrate (Lentocilin).
NC Medicaid is implementing changes to the Nursing Facility process to support providers and members.
The revised NC Medicaid 1915(i) Assessment includes new date fields and must be used starting Oct. 1, 2025.
NC Medicaid is announcing the Recovery Audit Contractors program kick-off and upcoming Provider Outreach webinar.
Current Procedural Terminology code 67516 has replaced category III code 0465T.
NC Medicaid is providing updated information to providers about new federal prohibitions on certain providers.
NC Medicaid is providing additional information to providers about new federal prohibitions on certain providers.
Based on prior authorization and claim changes, optical providers (ophthalmologists, optometrists and opticians) should review NCTracks enrollment status to ensure there is an individual optical provider enrolled at the practice location where the visual aids are being ordered.
Effective July 1, 2025, NC Medicaid adjusted the provider per diem.
New diagnosis codes now accepted for chiropractic services effective Aug. 1, 2024.