Topics Related to Division of Health Benefits

Information about a new Provider Directory API, recent provider communications, upcoming webinars and more.
Action Required: Providers with Active 251S00000X Taxonomy must select Service and meet national accreditation requirements within one year.
Action Required: Providers with Active 251S00000X Taxonomy must select New Service and Report National Accreditation.
Modifier CR should only be appended to procedure codes when services are directly related to a Federal or State-declared emergency or disaster.
The Centers for Medicare & Medicaid Services has released 80 new ICD-10-PCS codes, Effective April 1, 2026.
This bulletin updates the previously published NC Medicaid Direct Pharmacy Benefits Administrator Provider Transition Overview and Webinars bulletin.
NC Medicaid providers must accurately answer all Exclusion Sanction questions.
Following stakeholder engagement and review of departmental priorities, NC Medicaid will not be implementing the Advanced Medical Home (AMH) Standardized Performance Incentive Program (SPIP) at this time.
Evaluates the influence of NC Medicaid Transformation on primary care and obstetrics/gynecology practices that contract with NC Medicaid.
The Department is no longer requiring compliance with Tobacco-free Campus Policy Requirements by Jan. 1, 2027.