This bulletin replaces the previous bulletin published Nov. 21, 2022.
Blog Entry List
Replaces the prior version issued in February 2022
A multidisciplinary care team will provide whole-person care management that addresses all of a beneficiary’s needs
Upcoming milestones, Provider Playbook updates, organizational Provider affiliation requirement, Beneficiary assignment file and more
Vaccine Immunization Claims Can Be Submitted on Pharmacy Claims for NC Medicaid Direct Beneficiaries
Effective Dec. 1, 2022, pharmacy providers who administer immunizations at pharmacies may bill NC Medicaid Direct for vaccines on pharmacy claims
This bulletin provides guidance to assist hospital providers’ compliance with federal requirements.
Effective with date of service Oct. 3, 2022, Medicaid and NC Health Choice cover Ranibizumab-eqrn injection, (Cimerli)
Indigotindisulfonate Sodium Injection, for Intravenous Use (Bludigo™) HCPCS Code: Billing Guidelines
Effective with date of service Sept 30, 2022, Medicaid and NC Health Choice cover Indigotindisulfonate sodium injection (Bludigo)
Effective with date of service Oct. 5, 2022, Medicaid and NC Health Choice cover Bevacizumab-maly injection (Alymsys)
This error occurred when the LARC was filled by a point-of-sale pharmacy and inserted by the provider in the clinic.
Taxonomy numbers are not included in Clinical Policy but are included in the associated Fee Schedules.
Includes HCPCS Code G0512 for RHCs and FQHCs
We encourage stakeholders to provide feedback by Dec. 19, 2022.
The $20 PMPM Medical Home Payments for AMHs serving members eligible for Tailored Care Management will begin in December.