Topics Related to Bulletins
Forum to be held June 4-5 in Raleigh.
Coverage has been restored to definitive drug testing codes that exceed seven drug classes retroactive to Dec. 1, 2024.
Use Standard Plan and Tailored Plan provider portals or Real-Time Eligibility Electronic Data Interchange Transactions 270/271.
NC Medicaid added coverage for Healthcare Common Procedure Coding System (HCPCS) Code G0512 for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
An amended version of Clinical Coverage Policy 5A-3, Nursing Equipment and Supplies with an effective date of March 1, 2025, was posted to the NC Medicaid Clinical Coverage Policy web page.Summary of UpdatesIn the table Related Clinical Coverage Policies, added reference to clinical coverage policy 3D, Hospice Services.The terms ‘approval,’ ‘authorization’ and ‘prior authorization’ were changed to ‘prior approval’ for consistency throughout.
Starting April 15, 2025, Pre-Admission Screening and Resident Review (PASRR) users must use Multi-Factor Authentication (MFA) via MyNCID to enhance security.
This bulletin describes the changes required under CAA 5121 as well as reminders on the suspension of benefits during incarceration.
The PREP Act is extended to Dec. 31, 2029, expanding COVID-19 and flu vaccine access at pharmacy Point-of-Sale for ages 3 and older.
Effective Feb. 3, 2025, unless communicated otherwise by the Department