The Centers for Medicare & Medicaid Services (CMS) requires individuals in the NC Medicaid Innovations waiver program to have a valid and comprehensive assessment.
Blog Entry List
Budget proposals from the North Carolina General Assembly do not include funding for Healthy Opportunities Pilots services beyond June 30, 2025
Tobacco-related policy requirements will be effective starting on Jan. 1, 2027.
Care Management rate considerations effective July 1, 2025.
Reminder: NC Medicaid does not require Carolina Access/Advanced Medical Home referrals for specialty care.
NCTracks will align the suspension of DMH/DD/SUS health plans during the reverification process.
Individual provider enrollment and Additional Managed Care Options
Effective April 1, 2025: NC Medicaid amended Clinical Coverage Policy 1G-2.
Policy is updated effective May 1, 2025
Changes to the NCTracks provider application are coming in 2025.
NC Medicaid implements a more efficient method for submitting revision requests in active Clinical Coverage Policies.
Option to Create Secondary/Back-up Office Administrators
Effective May 1, 2025, NC Medicaid covers CPT 99483, Cognitive Assessment and Care Plan Service.
Effective May 1, 2025, NC Medicaid will provide coverage for CPT Code 0421U – ColoSense, a multi-target stool RNA-based colorectal cancer screening test.
Committee to make final decisions on submitted applications, quality determinations and compliance with regulatory requirements.