The audit will sample fee-for-service claims collected for a full year – July 1, 2024, through June 30, 2025.
Blog Entry List
New separately reimbursable CPT codes in the ambulatory surgery setting
Recent State Plan Amendment outlines duties of a responsible third party
Revised policy in addition to services outlined in Maternity Coverage and Reimbursement Bulletin posted Oct. 23, 2023.
Updates on the Sandata mobile app, telephony and fixed visit verification.
Providers should work with their Medicaid beneficiary’s health plan and Tailored Care Manager to transition the members to 1915(i) services.
The Centers for Medicare & Medicaid Services has approved State Plan Amendments to revise reimbursement methodology.
Highlights from Year 2
The next review panel meeting is April 11, 2024
This website includes resources to assist with completing the NC Medicaid application and information about becoming a Medicaid Ambassador.
Includes information on Provider Fact Sheets, LME/MCO consolidation, Innovations and TBI waivers, federal fee increase, updates to NCTracks and more.
Tobacco-Related Policy Requirements Delayed until July 1, 2027
Clinical Coverage Policy 8A, Enhanced Mental Health and Substance Abuse Services Update
An amended version of Clinical Coverage Policy 5A-3, Nursing Equipment and Supplies promulgated on March 1, 2024, with an effective date of Jan. 1, 2024.