Blog Entry List
This is an update to the September 2016 Medicaid Ordering, Prescribing or Referring Special Bulletin.
This bulletin has updated end dates & additional flexibilities for Behavioral Health, Care Management, Innovations, and Long-Term Services & Supports.
This bulletin applies to NC Medicaid Direct and NC Medicaid Managed Care. NC Medicaid is committed to ensuring continued access to care for NC Medicaid beneficiaries. As a service to both NC Medicaid beneficiaries and providers, NCTracks has created a webpage listing of all enrolled out-of-state (OOS) pharmacies, categorized by state.
This bulletin applies to NC Medicaid Direct.Please note the corrected effective dates for the following codes that were reported in bulletin article: CPT Code Update Effective Jan. 1, 2024. 87593 Detection of Orthopoxvirus- effective date 7/26/202290589 Chikungunya Virus Vaccine- effective date 2/28/2024Also note the following CPT codes are covered, effective 1/1/2024:
NC Medicaid will continue the current Tailored Care Management temporary payment rate of $343.97 statewide through June 30, 2025.
Effective Jan. 1, 2025, the unit of reimbursement will change from a 15-minute increment to a daily per diem.
Two policies will be effective on Jan. 1, 2025, and posted to the NC Medicaid website.
Includes information on vaccine reimbursement, billing, counseling coverage and Immunization Program/Vaccines for Children
Health plans are required to pay interest to providers if they fail to accurately pay or inappropriately deny a claim.
For providers unable to provide services under an active, approved service plan due to the impacts of Hurricane Helene.
This survey provides a national standard for assessing beneficiaries’ health care experience.
This bulletin applies to both NC Medicaid Direct and NC Managed Care health plans.Vaccine strains for the 2024–25 influenza vaccines were selected by the Food and Drug Administration’s Vaccines and Related Biologic Products Advisory Committee (VRBPAC) based on WHO’s recommended Northern Hemisphere 2024–25 influenza vaccine composition. For details on the 2024-2025 influenza vaccines, visit the Centers for Disease Control (CDC) Flu Season web page.
This bulletin contains information on updated flexibilities being implemented by NC Medicaid due to the Hurricane Helene Public Health Emergency.
Effective Dec. 1, 2024, some drug testing CPT codes will no longer be reimbursed in the outpatient setting.