Blog Entry List
Clarification to recent policy and billing questions
Information to share with beneficiaries to increase participation
Effective Sept. 1, 2024, NC Medicaid will begin covering condoms and spermicides as over-the-counter products, through the pharmacy benefit.
Effective Sept. 1, 2024, hospital OST claims submitted to NCTracks must include the individual OPR NPI.
Two FASTEP COVID 19 AG HOME TEST NDCs added to coverage.
Flexibilities effective Aug. 6, 2024, for NC Medicaid beneficiaries due to Tropical Storm Debby.
Changes are effective Aug. 1, 2024
Effective Aug. 1, 2024, Medicaid will require a primary diagnosis of spinal subluxation for NC Medicaid Direct claims.
Effective Aug. 1, 2024, over the counter oral contraceptive Opill will be available without a prescription, at no cost.
Effective Aug. 1, 2024, NC Medicaid will cover obesity management medications for beneficiaries 12 years of age and older.
Standard Plans will begin to reimburse the APM rate for claims with a date of service on or after Aug. 1, 2024.
Effective June 1, 2024, CPT codes are newly eligible for coverage.
Effective Dec. 1, 2023, updates increased treatment visit limits for beneficiaries aged 21 and older. The home health ordering practitioner reference was also updated.
Effective retroactive to April 1, 2023, Z31.430 and Z31.440 will be covered diagnosis codes in NCTracks.
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.