Blog Entry List
Claims without the required EVV data will be denied.
Nursing Facility Providers and Intermediate Care Facilities for Individuals with Intellectual Disabilities Targeted.
Vaccine strains for the 2023–24 influenza vaccines were selected by the Food and Drug Administration’s Vaccines and Related Biologic Products Advisory Committee based on WHO’s recommended Northern Hemisphere 2023–24 influenza vaccine composition. For details on the 2023-2024 influenza vaccines, visit the Centers for Disease Control (CDC) Flu Season web page.
Vaccine strains for the 2023–24 influenza vaccines were selected by the Food and Drug Administration’s Vaccines and Related Biologic Products Advisory Committee based on WHO’s recommended Northern Hemisphere 2023–24 influenza vaccine composition. For details on the 2023-2024 influenza vaccines, visit the Centers for Disease Control (CDC) Flu Season web page.
COVID-19 OTC Tests for home use are covered for full Medicaid enrollees through Sept. 30, 2024. Guidance for NC Medicaid coverage and the complete list of covered products are available on the Outpatient Pharmacy Services webpage. Updates to the covered products are below.
The North Carolina Department of Health and Human Services (the Department) is releasing updated information about the assumptions underlying the care management component of capitation payments to NC Medicaid Managed Care Prepaid Health Plan (PHPs) Standard Plans. The PHP Standard Plan capitation rates developed by the Department reflect its belief that investment in robust community-based care management will drive improvements in care outcomes and achieve greater value from the state’s Medicaid dollar.
This bulletin replaces NC Medicaid Temporary Flexibilities Due to Hurricane Idalia published on Aug. 30, 2023, to correct the end date.
Effective immediately, a nurse practitioner, clinical nurse specialist or a physician assistant may order home health services.
Provider guidance for reimbursement, enrollment and providing care for Medicaid beneficiaries
NC Medicaid is continuing the extension of the temporary/interim estimated legislative rate increases.
Final authority needs to be granted by the General Assembly
CPT code 99417 (Prolonged outpatient evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time) is now allowed to be billed with 99245, 99345 and 99350.
Includes provider recredentialing/reverification, Medicaid expansion, Tailored Plan implementation and more.
This bulletin provides information about referrals for specialty care for NC Medicaid beneficiaries.