Topics Related to Division of Health Benefits
Effective with date of service Jan. 1, 2025, new CPT codes have been added, some end-dated, and descriptions of some existing codes have been updated
Effective Jan. 1, 2025, NC Medicaid will cover U.S. Food & Drug Administration approved cell and gene therapies
Children with NC Medicaid temporarily living in another state can get a free Vaccine for Children (VFC) vaccine from any VFC provider in that state.
This is an update to the September 2016 Medicaid Ordering, Prescribing or Referring Special Bulletin.
This bulletin has updated end dates & additional flexibilities for Behavioral Health, Care Management, Innovations, and Long-Term Services & Supports.
The federal fee for Medicaid enrollment has increased to $730 for calendar year 2025.
This bulletin applies to NC Medicaid Direct and NC Medicaid Managed Care. NC Medicaid is committed to ensuring continued access to care for NC Medicaid beneficiaries. As a service to both NC Medicaid beneficiaries and providers, NCTracks has created a webpage listing of all enrolled out-of-state (OOS) pharmacies, categorized by state.
This bulletin applies to NC Medicaid Direct.Please note the corrected effective dates for the following codes that were reported in bulletin article: CPT Code Update Effective Jan. 1, 2024. 87593 Detection of Orthopoxvirus- effective date 7/26/202290589 Chikungunya Virus Vaccine- effective date 2/28/2024Also note the following CPT codes are covered, effective 1/1/2024:
NC Medicaid will continue the current Tailored Care Management temporary payment rate of $343.97 statewide through June 30, 2025.