Blog Entry List
It has come to the attention of NC Medicaid that Edit 02088, which enforces a rule that coverage of procedure code G9919 for Healthy Opportunities Screening, Assessment and Referrals (HOSAR) positive screenings, be limited to providers affiliated with Carolina Access II based on the rendering provider NPI.
Key Dates for Transitioning to Medicaid Managed Care, PHP Quick Reference Guides Created, Provider Contracting Reminders, Provider Playbook Updates, Medicaid Contacts Reference Guide for Beneficiaries, Help Center, Webinars, Virtual Office Hours, Meet and Greet Sessions.
NCDHHS announced today the launch of statewide open enrollment for NC Medicaid Managed Care. Beneficiaries can enroll through May 14, 2021 in preparation for NC Medicaid Managed Care launch on July 1, 2021.
The following new or amended clinical coverage policies are available on the Clinical Coverage Policies web page on NC Medicaid’s website.
The Advanced Medical Home Glidepath Attestation functionality is now live in NCTracks.
NC Medicaid has updated its Appendix K to extend flexibilities on how Medicaid providers and beneficiaries access and receive home- and community-based services through CAP/C, CAP/DA, NC Innovations waiver and Traumatic Brain Injury waiver.
Effective with date of service Jan. 1, 2021, the Centers for Medicare & Medicaid Services has identified new CPT and HCPCS codes as separately reimbursable in the ambulatory surgery setting.
Providers have until April 30, 2021, to submit a complete and accurate attestation for Program Year 2020. After that no changes can be made.
In addition to the NC Medicaid Provider webpage, Medicaid and NC Health Choice providers now have a supplemental resource to research their questions and submit inquiries.
NC Medicaid has released the NC Department of Health and Human Services Transition of Care Policy, which outlines NC Medicaid's vision on the process of assisting a beneficiary through the transition between health plans or between service/payment delivery systems.
The Department released the Advanced Medical Home Provider Manual 2.0 today. This version reflects program expectations as well as recent program modifications and changes that impact provider contracts.
CPT Code 87428 (related to COVID-19) was improperly defined in a previous Bulletin and is being correctly defined here.
Effective June 1, 2020, NC Medicaid began reimbursing COVID-19 testing for “Be Smart” Family Planning (MAFDN) beneficiaries through the NC Medicaid Optional COVID-19 Testing (MCV) Program. NC Medicaid is adding codes into NC Tracks for lab testing coverage for MAFDN beneficiaries with retroactive effective dates.
NC Medicaid is initiating its final phase of reconciling projected versus actual testing cost submission activity for nursing home staff testing payments authorized under Secretarial Orders 2 and 4 on March 1, 2021.
To continue supporting providers interested in obtaining certification as an Advanced Medical Home Plus (AMH+) practice or Care Management Agency (CMA), the Round 1 application deadline is being extended from March 1, 2021 to June 1, 2021.