Blog Entry List
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.
Effective retroactive to Jan. 1, 2022, CPT code 80050 will no longer be reimbursed.
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.
Expanding Pilot Eligibility to Members in NC Medicaid Direct in Pilot Regions
Billing Requirements for Medicaid Direct Providers
Look for details on training in June related to these changes.
The audit will sample fee-for-service claims collected for a full year – July 1, 2024, through June 30, 2025.