Effective July 26, 2020, Registered Dieticians and Nutritionists may enroll in Medicaid or the NC Health Choice program to provide and bill for this service for pregnant women and beneficiaries less than 21 years of age.
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Effective with date of service Jan. 1, 2020, the Medicaid and NC Health Choice programs cover famotidine injection (Pepcid®) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3490 - Unclassified drugs.
Effective with date of service Aug. 4, 2020, the Medicaid and NC Health Choice programs cover amisulpride injection, for intravenous use (Barhemsys®) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3490 - Unclassified drugs.
Effective with date of service Nov. 13, 2020, the Medicaid and NC Health Choice programs cover meningococcal [Groups A, C, Y, W] conjugate vaccine, solution for intramuscular injection (MenQuadfi™) for use in the Physician Administered Drug Program.
The latest version of the Third-Party Liability Medicaid and NC Health Choice billing guide is available.
The Tailored Care Management certification process is now open, and providers may submit applications.
NC Medicaid’s Electronic Visit Verification (EVV) system will launch on Jan. 1, 2021, for State Plan Personal Care Services, CAP/DA and CAP/C. During the first 90 days following launch, we will operate EVV as “Pay and Report.” EVV implementation for TBI waiver and LME-MCO services programs is planned for April 2, 2021.
Providers subject to EVV are required to utilize an electronic verification system to capture in-home visits to align with the state and federal guidelines. The enrollment or selection of an EVV vendor must be made by Dec. 18, 2020, to ensure NC Medicaid meets the Jan. 1, 2021 deadline for implementation.
Provider webinars in December include Advanced Medical Home on December 10, COVID-19 Vaccine Distribution on December 15, and Behavioral Health on December 17.
Key dates for transitioning to Medicaid Managed Care, contracting reminders, webinar series for providers and practice leaders, review your provider records in NCTracks, the Provider Ombudsman, PHP manuals updated and the beneficiary portal.
NC Medicaid State Plan Personal Care Services (PCS) and Community Alternatives Programs (CAP) providers who render personal care-type services, are required to complete a secure survey regarding Electronic Visit Verification (EVV) by Dec. 7, 2020.
Effective July 1, 2020, End Stage Renal Disease Treatment providers (261QE0700X) were added to the list of eligible providers for Procedure Code J0887, Mircera Injection, Epoetin Beta, 1 Microgram.
Effective Jan. 1, 2021, Personal Care Services and Community Alternatives Programs providers subject to Electronic Visit Verification will no longer be able to submit claims using span dating.
As announced previously, providers should not be submitting original claims for home health services using Bill Type 33X. Effective immediately, providers should use Bill Type 32X or 34X.
NC-MIPS is Open for Program Year 2020, Program Year 2020 Webinar Series, The Security Risk Analysis and Program Year 2021 Announcements.