Topics Related to Bulletins

Processing Claims Affected by Medicare Retroactive Enrollment

Guidance for providers directly billing Medicare for services provided to patients with retroactive Medicare enrollment dates

Updates to Clinical Coverage Policy 5B, Orthotics and Prosthetics

An amended version of Clinical Coverage Policy 5B, Orthotics and Prosthetics promulgated on July 15, 2024.

ICD-10 Annual Update Reminder

The 2025 ICD-10 update is effective Oct. 1, 2024, through Sept. 30, 2025, for provider use for dates of service within this period.

NC Medicaid Respiratory Syncytial Virus (RSV) Guidelines for 2024-2025

Guidance based on products approved by the FDA and recommended by the CDC Advisory Committee on Immunization Practices (ACIP).

NC Medicaid Behavioral Health I/DD Tailored Plans Federally Qualified Health Center /Rural Health Clinics PPS-APM wrap payment methodology

Reimbursement methodology changes revised to begin with dates of service on or after Dec. 1, 2024.

NC Medicaid Increasing Reimbursement Rates for the Substance Abuse Intensive Outpatient Program and Substance Abuse Comprehensive Outpatient Treatment

Rate Changes are Effective Aug. 1, 2024

Upcoming Changes to Service Location Management; Draft Applications to be Deleted

Effective Aug. 25, 2024, providers cannot modify an existing service location address in NCTracks without creating a new service location address

NC Medicaid to Cover Imported Benzathine Benzylpenicillin Tetrahydrate (Lentocilin): Billing Guidelines

Coverage effective for dates of service from July 26, 2024

NCTracks Multi-Factor Authentication (MFA) Updates Coming Soon for Individual & Business Users

Users must update their NCID profile by Sept. 6, 2024.

Clarification for Clinical Coverage Policies 5A-2, Respiratory Equipment and Supplies and 1A-20, Sleep Studies and Polysomnography Services

Clarification to recent policy and billing questions