Effective with date of service Jan. 1, 2020, the Medicaid and NC Health Choice programs cover famotidine injection (Pepcid®) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3490 - Unclassified drugs.
Topics Related to Bulletins
Effective July 26, 2020, Registered Dieticians and Nutritionists may enroll in Medicaid or the NC Health Choice program to provide and bill for this service for pregnant women and beneficiaries less than 21 years of age.
As Medicaid and NC Health Choice transition to managed care, beneficiaries will be notified to select a Prepaid Health Plan as well as a Primary Care Provider/Advanced Medical Home. Beneficiaries who do not self-select will be auto assigned by the Department.
Claim Denials for Sterilization CPT Code 58661
Updates on the consent form expiration date and clarifications related to the Aug. 15, 2020 policy update.
The Tailored Care Management certification process is now open, and providers may submit applications.
Providers subject to EVV are required to utilize an electronic verification system to capture in-home visits to align with the state and federal guidelines. The enrollment or selection of an EVV vendor must be made by Dec. 18, 2020, to ensure NC Medicaid meets the Jan. 1, 2021 deadline for implementation.
NC Medicaid’s Electronic Visit Verification (EVV) system will launch on Jan. 1, 2021, for State Plan Personal Care Services, CAP/DA and CAP/C. During the first 90 days following launch, we will operate EVV as “Pay and Report.” EVV implementation for TBI waiver and LME-MCO services programs is planned for April 2, 2021.
Key dates for transitioning to Medicaid Managed Care, contracting reminders, webinar series for providers and practice leaders, review your provider records in NCTracks, the Provider Ombudsman, PHP manuals updated and the beneficiary portal.
Provider webinars in December include Advanced Medical Home on December 10, COVID-19 Vaccine Distribution on December 15, and Behavioral Health on December 17.