Blog Entry List
Effective with the date of service Jan 1, 2021, the Centers for Medicare & Medicaid Services (CMS) has added new HCPCS codes (J codes), deleted others and changed the description of some existing codes.
Effective Jan. 1, 2021, many D-SNPs will be required to notify the state Medicaid agencies they contract with (or the state's designee) when their enrollees are admitted to a hospital or skilled nursing facility.
Effective with date of service Dec 12, 2020, the Medicaid and NC Health Choice programs cover Pfizer-BioNTech COVID-19 Vaccine for use in the Physician Administered Drug Program.
NC-MIPS is Open for Program Year 2020, Program Year 2020 Webinar Series, The Security Risk Analysis (SRA) and Program Year 2021 Announcements.
Effective with date of service Jan. 1, 2021, the American Medical Association has added new CPT codes, deleted others, and changed the descriptions of some existing codes.
This bulletin updates and extends NC Medicaid’s reimbursement for allowable COVID-19 testing of nursing facility staff and healthcare personnel.
Clinical Coverage Policy 1A-22, Medically Necessary Circumcision, has been revised and will post with an effective date of Jan. 1, 2021 on the NC Medicaid website.
An amended version of Clinical Coverage Policy 1E-7, Family Planning Services with an effective date of Dec. 1, 2020, was posted to the NC Medicaid Clinical Coverage Policy webpage.
Effective Oct. 1, 2020, NC Medicaid will now cover services for transversus abdominis plane blocks for Medicaid and NC Health Choice beneficiaries 11 years and older.
Program of All-inclusive Care for the Elderly (PACE) organizations should continue to follow the guidance of local, state and federal officials regarding COVID-19 and thoroughly document reasoning for making decisions which may fall outside of the PACE program model.
This bulletin revises the COVID-Response Site criteria established in SPECIAL BULLETIN COVID-19 #82.
Updates on the consent form expiration date and clarifications related to the Aug. 15, 2020 policy update.
Claim Denials for Sterilization CPT Code 58661
As Medicaid and NC Health Choice transition to managed care, beneficiaries will be notified to select a Prepaid Health Plan as well as a Primary Care Provider/Advanced Medical Home. Beneficiaries who do not self-select will be auto assigned by the Department.
Effective July 26, 2020, Registered Dieticians and Nutritionists may enroll in Medicaid or the NC Health Choice program to provide and bill for this service for pregnant women and beneficiaries less than 21 years of age.