Blog Entry List
Announcing Coverage-67516 Suprachoroidal Space Injection of Pharmacologic Agent (separate procedure)
Current Procedural Terminology code 67516 has replaced category III code 0465T.
Standard Plans will reimburse the APM rate for claims with a date of service on or after Aug. 1, 2024.
Providers can continue billing Diagnosis Related Group claims using revenue code 0161 for room and board and occurrence span code 82.
Temporary flexibilities to the Innovations Waiver after Hurricane Helene are ending July 1, 2025.
The Centers for Medicare & Medicaid Services (CMS) requires individuals in the NC Medicaid Innovations waiver program to have a valid and comprehensive assessment.
NC Medicaid’s Electronic Visit Verification (EVV) system for Home Health ensures compliance with federal requirements.
Reminder: NC Medicaid does not require Carolina Access/Advanced Medical Home referrals for specialty care.
Individual provider enrollment and Additional Managed Care Options
Policy is updated effective May 1, 2025
Public Comments Requested by May 30, 2025.
NC Medicaid’s Electronic Visit Verification (EVV) vendor, Sandata, will implement multi-factor authentication process for those accessing Sandata EVV and the Aggregator portals.
This bulletin describes the changes required under CAA 5121 as well as reminders on the suspension of benefits during incarceration.
The Per Diem Rate Methodology for Congregate Settings effective April 1, 2025.
This corrects the end-date for code G9920 in the December 2024 bulletin.
NC Medicaid’s Electronic Visit Verification (EVV) system for Home Health ensures compliance with federal requirements