Topics Related to Bulletins
Effective with date of service May 17, 2021, the Medicaid and NC Health Choice programs cover dostarlimab-gxly injection, for intravenous use (Jemperli) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.
Update on coverage of medications used in the Physician Administered Drug Program when billed with HCPCS code 90697.
CMS has added new HCPCS codes (J Codes), deleted others and changed the description of some existing codes.
Effective July 1, 2021, some Medicaid beneficiaries receiving Personal Care Services (PCS) transitioned from NC Medicaid Direct to receiving services through an NC Medicaid Managed Care health plan.
Health plans have identified a common billing error of providers submitting professional and institutional EDI claims.
Effective July 29, 2021, Session Law 2021-62 (NC Senate Bill 594), repeals portions of the 2020 COVID-19 Recovery Act that permitted the temporary lifting of certain enrollment requirements for providers enrolling in NC Medicaid during the global healthcare emergency.
Effective with date of service May 17, 2021, Medicaid and NC Health Choice cover dostarlimab-gxly injection.
This Bulletin includes key milestone dates for NC Medicaid Managed Care, Provider Playbook updates, prior authorization updates, contracting reminders, information about health plan events, the provider ombudsman and upcoming AHEC events and webinars. It also includes information about the Provider and Health Plan Lookup Tool, PHP Quick Reference Guide and the NC Medicaid Help Center.
This is a reminder to include taxonomy codes when submitting claims to PHPs, either by individual providers or through a trading partner.