Effective Dec. 1, 2022
Blog Entry List
An updated version effective Sept. 1, 2022, has been posted to the NC Medicaid Clinical Coverage Policy web page.
Point-of-sale (POS) billing for FDA-authorized over-the-counter (OTC) COVID-19 tests dispensed for use by NC Medicaid beneficiaries in a home setting remains in effect for NC Medicaid Direct and all five managed care plans.
Revised EVV for Home Health Services implementation dates for NC Medicaid Direct, Standard Plans and Tailored Plans.
Effective Jan. 1, 2023, new HCPCS procedure code G0330, Facility Services Dental Rehab, will be added to Clinical Coverage Policy 4A, Dental Services.
In May 2020, CMS updated the Minimum Data Set (MDS) 3.0 item sets to support calculation of Patient-Driven-Payment-Model (PDPM) case mix groups on OBRA assessments. In October 2020, NC Medicaid began requiring the completion and submission of the 28 MDS item set fields associated with PDPM on all OBRA nursing home comprehensive (NC) and quarterly (NQ) MDS assessment submissions.
Effective with date of service Jan. 1, 2023, the American Medical Association (AMA) has added new CPT codes, deleted others, and changed the descriptions of some existing codes. For complete information regarding all CPT codes and descriptions, refer to the 2023 edition of Current Procedural Terminology, published by the AMA.
Beneficiaries can apply for various benefits, view case details, renew their Medicaid and update their information
Last days for providers to have fully executed contracts with Tailored Plans to be included in the beneficiary choice period and auto-assignment.
Highlighting coverage, rate and resource changes in 2022
Changes requirement to “comprehensive annual exam or annual assessment” prior to providing family planning and related services.
Documents modifying the Skilled Nursing Facilities Provider Assessment and temporary COVID-19 add-on, and SNF per diem rates are impacted.
Effective with date of service Oct. 19, 2022, Medicaid and NC Health Choice cover Sodium Thiosulfate injection, for intravenous use (Pedmark).
Effective with date of service Nov. 15, 2022, Medicaid and NC Health Choice cover Eflapegrastim-xnst injection, for subcutaneous use (Rolvedon).
When the service location field is not completed, the Alt EVV vendor will receive an exception notice.