On April 20, 2027, the Innovations Waiver “Community/Behavioral Health” Service under taxonomy 251S00000X will be end-dated on provider records.
Blog Entry List
Effective May 2, 2026, use of the pharmacy National Provider Identifier in the prescriber field on Point-of-Sale claims for all protocol drugs will no longer be allowed.
Local Health Departments will continue to offer Care Management for At Risk Children and Care Management for High-Risk Pregnancy services to Medicaid beneficiaries, with Per Member Per Month payments remaining in effect, both through Dec. 31, 2026.
Prime Therapeutics is the New Pharmacy Benefit Administrator for NC Medicaid Direct Point of Sale Pharmacy, effective May 2, 2026.
These revisions are a result of the Current Dental Terminology CDT-2026 American Dental Association (ADA) code updates.
These revisions are a result of the Current Dental Terminology CDT-2026 American Dental Association (ADA) code updates.
Information about a new Provider Directory API, recent provider communications, upcoming webinars and more.
Action Required: Providers with Active 251S00000X Taxonomy must select New Service and Report National Accreditation.
Action Required: Providers with Active 251S00000X Taxonomy must select Service and meet national accreditation requirements within one year.
Modifier CR should only be appended to procedure codes when services are directly related to a Federal or State-declared emergency or disaster.
The Centers for Medicare & Medicaid Services has released 80 new ICD-10-PCS codes, Effective April 1, 2026.
Following stakeholder engagement and review of departmental priorities, NC Medicaid will not be implementing the Advanced Medical Home (AMH) Standardized Performance Incentive Program (SPIP) at this time.
This bulletin updates the previously published NC Medicaid Direct Pharmacy Benefits Administrator Provider Transition Overview and Webinars bulletin.
NC Medicaid providers must accurately answer all Exclusion Sanction questions.
Evaluates the influence of NC Medicaid Transformation on primary care and obstetrics/gynecology practices that contract with NC Medicaid.