Effective with the date of service April 1, 2021, the Centers for Medicare & Medicaid Services added new HCPCS codes (J codes), deleted others and changed the description of some existing codes.
Topics Related to Bulletins
Effective July 1, 2021, NC Medicaid will increase fee-for-service rates and establish rate floors for facility-based crisis and mobile crisis management services that will mandate minimum reimbursement rates.
An updated draft of NC Medicaid’s Managed Care Quality Strategy is posted for public comments until May 6, 2021.
Program Year 2020 Webinar Series, The Security Risk Analysis (SRA) and Program Year 2021 Announcements.
The following new or amended clinical coverage policies are available on the Clinical Coverage Policies web page on NC Medicaid’s website.
The NC Medicaid Annual Quality report and an updated NC Medicaid Managed Care Quality Measurement Technical Specifications Manual are available.
NCDHHS has implemented a PCP practice reassignment process to better match beneficiaries to the PCP with whom they already have an active relationship with to help ensure the best health plan is selected during auto-enrollment.
Upcoming stakeholder sessions are announced for the Community Alternatives Program for Children (CAP/C) waiver, which will expire on Feb. 28, 2022. By October 2021, NC Medicaid will submit a request to the Centers for Medicare and Medicaid Services (CMS) to renew the CAP/C waiver.
Cabotegravir and Rilpivirine Co-Packaged for IM Use (Cabenuva™) HCPCS Code J3490: Billing Guidelines
Effective with date of service Feb. 1, 2021, the Medicaid and NC Health Choice programs cover cabotegravir extended-release injectable suspension; rilpivirine extended-release injectable suspension, co-packaged for intramuscular use (Cabenuva™).
Effective with date of service Jan. 28, 2021, the Medicaid and NC Health Choice programs cover remimazolam for injection, for intravenous use (Byfavo™).