Standard Plans will begin to reimburse the APM rate for claims with a date of service on or after Aug. 1, 2024.
Blog Entry List
Providers need to submit new prior authorizations (PA) for services subject to 42 Code of Federal Regulations (CFR) Part II.
Effective Aug. 1, 2024, NC Medicaid will cover obesity management medications for beneficiaries 12 years of age and older.
Effective Aug. 1, 2024, over the counter oral contraceptive Opill will be available without a prescription, at no cost.
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 June 1, 2024, CPT codes are newly eligible for coverage.
Providers should work with the Tailored Plans and Tailored Care Managers to support Medicaid beneficiaries transitioning to 1915(i) services.
This bulletin applies to NC Medicaid Managed Care Standard Plans.
AMH Provider Manual May 2024 reflects all program modifications and changes that impact provider contracts and operations.
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.
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.
Feedback Requested on Proposed Approach