Topics Related to Division of Health Benefits

Providers should work with the Tailored Plans and Tailored Care Managers to support Medicaid beneficiaries transitioning to 1915(i) services.

AMH Provider Manual May 2024 reflects all program modifications and changes that impact provider contracts and operations.

This bulletin applies to NC Medicaid Managed Care Standard Plans.

Effective retroactive to April 1, 2023, Z31.430 and Z31.440 will be covered diagnosis codes in NCTracks.  

Training for Providers begins Friday, June 28. Additional dates are listed in this bulletin.

This bulletin applies to NC Medicaid Managed Care and NC Medicaid Direct.

Medicaid corrected the reimbursement issue and reprocessed claims for nerve conduction tests performed by physical therapists.

Provider Data Management / Credentialing Verification Organization (PDM/CVO) Solution New Launch Date of 2026.
Includes information on the New Launch Date for PDM/CVO, Healthy Opportunities Pilot, Provider Fact Sheets, Reverification Updates and more.

Effective retroactive to Jan. 1, 2022, CPT code 80050 will no longer be reimbursed.

The PDM/CVO solution will consolidate provider data management and coordinate provider enrollment, credentialing, and ongoing data maintenance.