NC Medicaid has released the NC Department of Health and Human Services Transition of Care Policy, which outlines NC Medicaid's vision on the process of assisting a beneficiary through the transition between health plans or between service/payment delivery systems.
Topics Related to Bulletins
Providers have until April 30, 2021, to submit a complete and accurate attestation for Program Year 2020. After that no changes can be made.
Effective with date of service Jan. 1, 2021, the Centers for Medicare & Medicaid Services has identified new CPT and HCPCS codes as separately reimbursable in the ambulatory surgery setting.
The public comment period has been extended through March 15, 2021, for Personal Care Services Policy 3L, Implementation of Electronic Visit Verification.
CPT Code 87428 (related to COVID-19) was improperly defined in a previous Bulletin and is being correctly defined here.
To continue supporting providers interested in obtaining certification as an Advanced Medical Home Plus (AMH+) practice or Care Management Agency (CMA), the Round 1 application deadline is being extended from March 1, 2021 to June 1, 2021.
NC Medicaid is initiating its final phase of reconciling projected versus actual testing cost submission activity for nursing home staff testing payments authorized under Secretarial Orders 2 and 4 on March 1, 2021.
Effective June 1, 2020, NC Medicaid began reimbursing COVID-19 testing for “Be Smart” Family Planning (MAFDN) beneficiaries through the NC Medicaid Optional COVID-19 Testing (MCV) Program. NC Medicaid is adding codes into NC Tracks for lab testing coverage for MAFDN beneficiaries with retroactive effective dates.
North Carolina Medicaid has received calls concerning claim denials for some services provided by nurse practitioners (NPs) and physician assistants (PAs).
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.