Blog Entry List

CMS has added new HCPCS codes (J Codes), deleted others and changed the description of some existing codes.

All Carolina Access Providers who received health equity payments are asked to take 5-10 minutes to complete a survey by Friday, July 30, 2021. The survey allows DHHS to monitor and evaluate how these payments were used.

Prepaid Health Plans (PHPs) began providing non-emergency medical transportation (NEMT) and non-emergency ambulance transportation (NEAT) services for PHP members on July 1, 2021.

Health plans have identified a common billing error of providers submitting professional and institutional EDI claims.

Data system guidance and strategy Q&As are now available

Effective with date of service May 17, 2021, Medicaid and NC Health Choice cover dostarlimab-gxly injection.

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.

ADDENDUM to Special Bulletin #168: The addendum was updated to include information regarding guidance on billing and coding criteria, guidance for parents, counseling methods, reimbursement ranges and the time frame during which the code is valid.

This Special Bulletin is being released to inform NC Medicaid providers of COVID-19 rate reimbursement that providers will receive from Prepaid Health Plans (PHPs) under NC Medicaid Managed Care.

This is a reminder to include taxonomy codes when submitting claims to PHPs, either by individual providers or through a trading partner.

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.

A new clinical coverage policy, 1S-5 Genetic Testing for Susceptibility to Breast and Ovarian Cancer, became effective July 1.

Carolina Access Providers who received health equity payments are asked to complete this survey by July 16.

Additional information on prior authorization is available.

On July 1, 2021, an amended version of the policy was posted.