Blog Entry List

Temporary flexibilities and changes run from Dec. 1, 2022, to March 31, 2023.
NCDHHS will delay the implementation of North Carolina Standard Plan and Tailored Plan Tobacco-Free Policy requirements.
Please post in a prominent location such as patient waiting rooms as soon as possible.
Providers are encouraged to review for an overview of other general language and formatting updates.

About the Trails Program

All fee schedules currently listed on the NC Medicaid website have been moved to a new Fee Schedule and Covered Code Portal available to the public.
Effective with date of service August 31, 2022, Medicaid and NC Health Choice cover Pfizer-BioNTech COVID-19 Vaccine
Effective with date of service Aug. 31, 2022, Medicaid and NC Health Choice programs cover Moderna COVID-19 Vaccine
Effective Nov. 3, 2022, fee schedules currently listed on the NC Medicaid website will move to a new public fee schedule and covered code website.
Effective Oct. 1, 2022, Pluvicto must be billed with HCPCS code A9607
The delay in conducting assessments has slowed the generation of prior approvals for the continuation of PCS.
Updated HCPCS Code, unit of coverage and maximum reimbursement rate
Key milestones, playbook updates, beneficiary eligibility, reverification, provider records, provider ombudsman, help center and webinars.
This bulletin specifies Medicaid flexibilities ending with the Hurricane Ian state of emergency and those remaining as part of the Federal COVID-19 public health emergency.
For NC Medicaid Direct Home Health Care Service Providers Who Elect Sandata, NC Medicaid’s Free Solution