Fact sheets covering Provider payment, reimbursement, claims submissions and prior authorization have been recently published on the NC Medicaid website.
Blog Entry List
Effective July 1, 2023, the visit record must match the claim submitted to NCTracks. This bulletin provides additional information and resources.
Effective Jan. 1, 2023, the minimum age was adjusted from 50 years to 45 years.
FDA approvals of these drugs were withdrawn.
Effective with date of service Jan. 1, 2023, the following new CPT codes as separately reimbursable in the ambulatory surgery setting
The review must be performed before anyone can be admitted to a Medicaid-Certified nursing facility.
The federal COVID-19 Public Health Emergency (PHE) ends today, May 11, 2023. This bulletin contains information on the reverification process.
The federal COVID-19 Public Health Emergency (PHE) will end May 11, 2023. This bulletin contains important information on the reverification process.
Federal support ending for Resource Utilization Groups III and IV on federally required assessments for patients effective Oct. 1, 2023.
Effective with date of service Jan. 27, 2023, Medicaid and NC Health Choice cover lenacapavir injection
Effective with date of service Jan. 30, 2023, the Medicaid and NC Health Choice programs cover bendamustine hydrochloride injection, for intravenous use (Baxter).
Effective with date of service Jan. 27, 2023, the Medicaid and NC Health Choice programs covers ublituximab-xiiy injection, for intravenous use (Briumvi)
Pegfilgrastim-FpgkInjection, for Subcutaneous Use (Stimufend®) HCPCS Code J3590 - Billing Guidelines
Effective with date of service Jan. 23, 2023, the Medicaid and NC Health Choice programs cover pegfilgrastim-fpgk
Effective with date of service Jan. 20, 2023, the Medicaid and NC Health Choice programs cover fecal microbiota, live - jslm suspension, for rectal use (Rebyota).
Effective April 1, 2023, NC Medicaid covers ambulatory blood pressure monitoring. This helps confirm or exclude suspected hypertension.