Blog Entry List
The five-year cost of dispensing survey has been completed for North Carolina pharmacies.
Includes medical and pharmacy prior authorizations, out-of-network provider rates and rules and primary care provider changes.
The fact sheet outlines the key responsibilities of practices receiving auto-assigned members.
Effective Oct. 1, 2025, NC Medicaid will no longer cover the prescription drug Xifaxan (Rifaximin).
Providers can no longer bill NC Medicaid for Hospital at Home for dates of service on or after Oct. 1, 2025.
Flexibilities effective Sept. 26, 2025, for NC Medicaid beneficiaries due to Hurricane Humberto and Tropical Storm Invest 94L (Potential Imelda).
Fee schedules impacted by rate reductions will be released Oct. 1 2025, but are subject to change if additional appropriations are made available.
Current Procedural Terminology (CPT) code 99177, Screening of Eye with Special Instrument Onsite Analysis is separately reimbursable effective Nov. 1, 2024.
NC Medicaid is providing additional information to providers about new federal prohibitions on certain providers.
Join NC Medicaid and the Health Plans on October 8 for the virtual quality forum
Providers and pharmacies should always use NCTracks to confirm Medicaid eligibility
Effective Sept. 16, 2025, the Total Cost of Care Dashboard is decommissioned.
NC Medicaid is providing additional information to providers about new federal prohibitions on certain providers.
The purpose of this bulletin update is to provide clarification that Current Procedural Terminology (CPT) Code 99494 is allowed to be billed up to four times per month, effective July 1, 2024.
The first meeting for the new Credentialing Committee is slated for Oct. 8, 2025.