Blog Entry List

Effective Aug. 1, 2024, over the counter oral contraceptive Opill will be available without a prescription, at no cost.
Effective June 1, 2024, CPT codes are newly eligible for coverage.
Impacts NC Medicaid Managed Care Standard Plans, Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans and LME/MCOs.
Providers should work with the Tailored Plans and Tailored Care Managers to support Medicaid beneficiaries transitioning to 1915(i) services.
AMH Provider Manual May 2024 reflects all program modifications and changes that impact provider contracts and operations.

This bulletin applies to NC Medicaid Managed Care Standard Plans.

Effective retroactive to April 1, 2023, Z31.430 and Z31.440 will be covered diagnosis codes in NCTracks.  

This bulletin applies to NC Medicaid Managed Care and NC Medicaid Direct.

Medicaid corrected the reimbursement issue and reprocessed claims for nerve conduction tests performed by physical therapists.
Provider Data Management / Credentialing Verification Organization (PDM/CVO) Solution New Launch Date of 2026. Includes information on the New Launch Date for PDM/CVO, Healthy Opportunities Pilot, Provider Fact Sheets, Reverification Updates and more.
Effective retroactive to Jan. 1, 2022, CPT code 80050 will no longer be reimbursed.
The PDM/CVO solution will consolidate provider data management and coordinate provider enrollment, credentialing, and ongoing data maintenance.
Providers should review Clinical Coverage Policy 2A-1 for information on Hospital Observation
Usage of the Nicotine Replacement Therapy Protocol is Eligible for Clinical Services Reimbursement to Pharmacies.
Members may now select to receive Tailored Care Management from a provider with Transition to Community Living Distinction.