Providers have until April 30, 2018, to submit a complete and accurate attestation for Program Year 2017.
Topics Related to Bulletins
If a provider’s enrollment application or Manage Change Request (MCR) is clean and does not contain errors, it will process more quickly. The NCTracks Enrollment Team identified commons errors that cause delays in processing applications and MCRs.
The following new or amended combined North Carolina Medicaid and NC Health Choice clinical coverage policies are available on North Carolina Medicaid’s Clinical Coverage Policy web pages.
This article covers: Clinical Coverage Policy 12B and State Plan Amendment, 2018 Recertification Process, Stakeholder Engagement and, History and Purpose of HIV Case Management Services.
Effective Jan. 15, 2018, updates to Clinical Coverage Policy 3D, Hospice Services, are approved. The amended policy is posted to the North Carolina Medicaid website.
Revisions to the policy include the implementation of:
Effective with date of service Nov. 8, 2017, the North Carolina Medicaid program covers zoster vaccine recombinant, adjuvanted, suspension for intramuscular injection (Shingrix) for use in the Physician’s Drug Program (PDP) when billed with CPT code 90750 - Zoster (shingles) vaccine, (HZV), recombinant, sub-unit, adjuvanted, for intramuscular injection.
Effective with date of service Nov. 15, 2017, the North Carolina Medicaid and NC Health Choice programs cover rolapitant injectable emulsion, for intravenous use (Varubi) for use in the Physician’s Drug Program when billed with HCPCS code J3490 - Unclassified drugs
Effective with date of service, Nov. 15, 2017, the North Carolina Medicaid and NC Health Choice programs cover delafloxacin for injection, for intravenous use (Baxdela), for use in the Physicians Drug Program when billed with HCPCS code J3490 - Unclassified Drugs.
Effective with date of service, June 1, 2016, the North Carolina Medicaid and N.C. Health Choice programs cover NETSPOT for use in the Physician’s Drug Program when billed with HCPCS code A4641, radiopharmaceutical, diagnostic, not otherwise classified.
Effective with date of service June 1, 2016, the North Carolina Medicaid and NC Health Choice programs cover methacholine chloride (Provocholine) administered as inhalation solution, for use in the Physician’s Drug Program when billed with HCPCS code J7674 (Methacholine chloride, neb, per 1 mg).