Topics Related to Bulletins
The following new or amended Medicaid and NC Health Choice clinical coverage policies were posted since Aug. 31, 2018.
Proposed new or amended Medicaid and NC Health Choice clinical coverage policies are posted for comment throughout the month. Visit the Proposed Medicaid and NC Health Choice Policies for current posted policies and instructions to submit a comment.
Providers are reminded that NC Medicaid flexibilities due to Hurricane Florence end on Oct. 5, 2018.
The North Carolina Department of Health and Human Services developed the Advanced Medical Home program as the primary vehicle for delivering local care management as the state transitions to Medicaid managed care.
Effective with date of service, Aug. 1, 2018, the Medicaid and NC Health Choice programs cover Lutathera for use in the Physician’s Drug Program when billed with HCPCS code A9699, Radiopharmaceutical, therapeutic, not otherwise classified.
Providers may request prior approval for polycarbonate lenses without medical justification or additional documentation when eligible beneficiaries meet at least one of the following criteria.
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.
Registration is open for the September 2018 instructor-led provider training courses.
NC-MIPS is accepting Program Year 2018 Modified Stage 2 and Stage 3 MU attestations.
In response to provider requests and to allow reimbursement for behavioral health integration in primary care settings, North Carolina Medicaid is adding coverage for the following evaluation and management codes effective October 1, 2018.