Provider Taxonomy codes required when submitting claims to Tailored Plans.
Guidance for providers directly billing Medicare for services provided to patients with retroactive Medicare enrollment dates
Providers are encouraged to contact health plans to address any discrepancies in claim payment issues prior to escalating to the Provider Ombudsman
The 2025 ICD-10 update is effective Oct. 1, 2024, through Sept. 30, 2025, for provider use for dates of service within this period.
Guidance based on products approved by the FDA and recommended by the CDC Advisory Committee on Immunization Practices (ACIP).
Reimbursement methodology changes revised to begin with dates of service on or after Dec. 1, 2024.
Coverage effective for dates of service from July 26, 2024
Effective Aug. 25, 2024, providers cannot modify an existing service location address in NCTracks without creating a new service location address
Rate Changes are Effective Aug. 1, 2024
Clarification to recent policy and billing questions
Updates for providers on 1915(b)(3) services ending, new 1915(i) assessment tool and 1915(i) reassessments.
The NC Medicaid Community Alternatives Program for Disabled Adults (CAP/DA) §1915(c) Home and Community-Based Services (HCBS) expires Oct. 31, 2024. NC Medicaid is seeking to renew the waiver for another five years.
Users must update their NCID profile by Sept. 6, 2024.
Information to share with beneficiaries to increase participation
Effective Sept. 1, 2024, NC Medicaid will begin covering condoms and spermicides as over-the-counter products, through the pharmacy benefit.