Blog Entry List
Based on prior authorization and claim changes, optical providers (ophthalmologists, optometrists and opticians) should review NCTracks enrollment status to ensure there is an individual optical provider enrolled at the practice location where the visual aids are being ordered.
Effective July 1, 2025, NC Medicaid adjusted the provider per diem.
New diagnosis codes now accepted for chiropractic services effective Aug. 1, 2024.
Effective July 3, 2025, claims submitted without the ordering or referring physician National Provider Identifier will be adjudicated with a pay status for the Community Alternatives Program for Children and Disabled Adults.
In recent months, NC Medicaid has published three survey reports that detail the experiences of beneficiaries and providers in North Carolina during 2024.
Effective July 1, 2025, NC Medicaid adjusted the provider assessment rates.
Primary Care Provider (PCP) contracting deadline for Beneficiary Choice Period is Sept. 1, 2025.
Effective July 1, 2025, NC Medicaid will provide coverage for CPT Code 81515 – Xpert® Xpress MVP
Reimbursement methodology changes revised to begin with dates of service on or after Dec. 1, 2024.
Effective July 1, 2025, NC Medicaid adjusted the provider assessment rates.
The North Carolina Department of Health and Human Services (NCDHHS), through General Dynamics Information Technology, Inc. (GDIT), will establish a Credentialing Committee to review files that contain flagged items for disposition of their enrollment, reenrollment and recredentialing applications and issues discovered through ongoing monitoring. This will apply to all providers enrolling with:
Information on Provider Ombudsman, Children and Families Specialty Plan and Upcoming Credentialing Changes.
Standard Plans will reimburse the APM rate for claims with a date of service on or after Aug. 1, 2024.
Effective July 1, 2025, NC Medicaid adjusted the provider assessment rates.
The Tailored Care Management payment rate is $294.86 effective July 1, 2025.