North Carolina Medicaid has received calls concerning claim denials for some services provided by nurse practitioners (NPs) and physician assistants (PAs).
Topics Related to Bulletins
The Community Alternatives Program for Children (CAP) §1915(c) Home- and Community-Based Services (HCBS) waiver 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.
Effective with date of service Jan 5, 2021, the Medicaid and NC Health Choice programs cover rituximab-arrx injection, for intravenous use (Riabni™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3590 - Unclassified biologics.
Effective with date of service Dec. 22, 2020, the Medicaid and NC Health Choice programs cover lumasiran injection, for subcutaneous use (Oxlumo™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3490 - Unclassified drugs.
This bulletin informs LME-MCOs and providers about the amendments made to providers types eligible to bill the Screening, Brief Intervention and Referral to Treatment (SBIRT) CPT codes effective as of March 1, 2021.
The latest information providers need to know about the transition to Medicaid Managed Care. Update includes the Provider Directory and Health Plan Look-Up Tool, contracting reminders, Provider Playbook updates, upcoming webinars and more.
The Centers for Medicare & Medicaid Services and the American Medical Association have announced the release of several new codes to report testing for COVID-19.
NC Medicaid acknowledges challenges with implementing EVV and is extending flexibilities for EVV dates of service to providers who make a good faith effort to connect with their EVV vendor of choice.
Additional criteria has been added to identify beneficiaries as eligible for Behavioral Health I/DD Tailored Plans.
The U.S. Food and Drug Administration has issued an Emergency Use Authorization to permit the emergency use of the unapproved monoclonal antibodies to be administered for the treatment of mild to moderate COVID-19 in some patients.