Topics Related to Bulletins
Effective with date of service Dec. 31, 2019, the Medicaid and NC Health Choice programs cover enfortumab vedotin-ejfv for injection, for intravenous use (Padcev) for use in the Physician Administered Drug Program when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.
Effective with date of service Jan. 6, 2020, Medicaid and NC Health Choice programs cover fam-trastuzumab deruxtecan-nxki for injection, for intravenous use (Enhertu) for use in the Physician Administered Drug Program when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.
Effective March 1, 2020, Medicaid will begin issuing letters to PDN agencies addressing non-compliance with the timely submission of required documentation as indicated in the Request for Additional Information notice.
NC Medicaid is committed to ensuring our beneficiaries continue to receive Medicaid and NC Health Choice services with no interruptions or delays due to the novel coronavirus (COVID-19) outbreak. A webcast has been scheduled to discuss temporary modifications to certain policies and provide related billing codes.
The department is releasing a Behavioral Health Crisis System Memo for Standard Plans
The Department has extended the public comment period for the Behavioral Health I/DD Tailored Plan Request for Applications Pre-Release Policy Paper published on Jan. 30, 2020.
NC-MIPS is Open for Program Year 2019; The Security Risk Analysis (SRA); Reminder from CMS Regarding Objective 6 and Objective 7; Clarification from CMS Regarding Objective 5 Measure 1: Patient Electronic Access and General Reminders.
Effective with date of service Jan. 1, 2020, the Centers for Medicare & Medicaid Services (CMS) has identified some new CPT and HCPCS codes for reimbursement in ambulatory surgery.
NC Medicaid has provided instructions to NCTracks on updating the claims processing system. The following procedure code list has been updated recently to include additional NP and PA taxonomies.
The North Carolina State Health Director’s Standing Order for Naloxone authorizes any pharmacist practicing in the state of North Carolina and licensed by the North Carolina Board of Pharmacy to dispense naloxone to any person who meets the set criteria.