Topics Related to Bulletins

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 2/28/2024

Also note the following CPT codes are covered, effective 1/1/2024:

Comments accepted through Jan. 6, 2024.
NC Medicaid will continue the current Tailored Care Management temporary payment rate of $343.97 statewide through June 30, 2025.
Includes information on Change of Ownership Requirement, Upcoming Webinars, and more.
Effective Jan. 1, 2025, the unit of reimbursement will change from a 15-minute increment to a daily per diem.
Two policies will be effective on Jan. 1, 2025, and posted to the NC Medicaid website.
Includes information on vaccine reimbursement, billing, counseling coverage and Immunization Program/Vaccines for Children
Health plans are required to pay interest to providers if they fail to accurately pay or inappropriately deny a claim.
Enrolled providers must notify the Department at least 30 days prior to the effective date of a change of ownership.