Wegovy and Zepbound for indications other than weight loss to be covered based on the indications and usage criteria published in the FDA label, pending updated clinical criteria.
Topics Related to Bulletins
A psychiatric diagnostic interview (Current Procedural Terminology 90792) may qualify as a Comprehensive Clinical Assessment if it meets all requirements.
Effective Oct. 1, 2025, NC Medicaid adjusted the provider assessment rates.
This bulletin replaces in full NC Medicaid Rate Reductions – Effective Oct. 1, 2025, published Sept. 25, 2025.
Important changes effective Oct. 1, 2025, for providers with any form of license limitation.
The five-year cost of dispensing survey has been completed for North Carolina pharmacies.
Includes medical and pharmacy prior authorizations, out-of-network provider rates and rules and primary care provider changes.
The fact sheet outlines the key responsibilities of practices receiving auto-assigned members.
Effective Oct. 1, 2025, NC Medicaid will no longer cover the prescription drug Xifaxan (Rifaximin).
Providers can no longer bill NC Medicaid for Hospital at Home for dates of service on or after Oct. 1, 2025.