This bulletin replaces the NC Medicaid Respiratory Syncytial Virus (RSV) Guidelines for 2023-2024 - Revised published Nov. 3, 2023.
Blog Entry List
The American Medical Association has added new CPT codes, deleted others and changed the descriptions of some existing codes.
Effective with date of service Aug. 15, 2023, the NC Medicaid programs cover elranatamab-bcmm injection, for subcutaneous use (Elrexfio).
Effective with date of service Sept. 1, 2023, NC Medicaid covers talquetamab-tgvs injection, for subcutaneous use (Talvey).
Effective with date of service Sept. 6, 2023, NC Medicaid Direct and NC Medicaid Managed Care cover avacincaptad pegol intravitreal solution (Izervay)
Effective with date of service Sept. 1, 2023, NC Medicaid Direct and NC Medicaid Managed Care cover cantharidin topical solution (Ycanth).
Effective with date of service Aug. 21, 2023, Medicaid covers aflibercept injection, for intravitreal use (Eylea HD)
Effective with date of service Aug. 19, 2023, NC Medicaid covers pozelimab-bbfg injection, for intravenous or subcutaneous use (Veopoz).
Flexibilities in the approved amendment will be effective March 1, 2024, and considered ongoing
The updated policy aims to minimize the impact of health plan accreditation on delegated care management entities
North Carolina Medicaid will reimburse pharmacies for utilizing the statewide Self-Administered Hormonal Contraceptive Protocol for pharmacists.
NC Medicaid and the Division of Public Health (DPH) are alerting providers to the increased prevalence of syphilis in women of reproductive age; existing standards of care include testing all pregnant women at first prenatal visit, between 28-32 weeks and at delivery; and NC state law on sexually transmitted diseases.
This bulletin replaces NC Medicaid COVID-19 Vaccine and Reimbursement Guidelines for 2023-2024
Effective with date of service June 14, 2023, NC Medicaid covers pegunigalsidase alfa-iwxj injection, for intravenous use (Elfabrio).
Effective July 15, 2023, NC Medicaid covers beremagene geperpavec-svdt biological suspension mixed with excipient gel for topical application