Upcoming milestones, Provider Playbook updates, organizational Provider affiliation requirement, Beneficiary assignment file and more
Blog Entry List
This bulletin provides guidance to assist hospital providers’ compliance with federal requirements.
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 error occurred when the LARC was filled by a point-of-sale pharmacy and inserted by the provider in the clinic.
Effective with date of service Oct. 5, 2022, Medicaid and NC Health Choice cover Bevacizumab-maly injection (Alymsys)
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. 3, 2022, Medicaid and NC Health Choice cover Ranibizumab-eqrn injection, (Cimerli)
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.
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.
Effective with date of service August 31, 2022, Medicaid and NC Health Choice cover Pfizer-BioNTech COVID-19 Vaccine