This information replaces the reimbursement guidelines posted in the December 2019 bulletin.
Blog Entry List
Billing Reimbursement for second booster
Billing Guideline for use of Evusheld
Capacity building FAQs, guidance on the use of extenders, standard terms and conditions, and Provider Manual updates.
The Medicaid NCCI edits for the most recent quarter are published on the CMS website.
Approved for beneficiaries over the age of 21, effective July 1, 2021
NC Medicaid received approval to increase NC Innovations Waiver capacity by 1,000 slots.
With the end of the federal Public Health Emergency (PHE) expected in the Summer of 2022, NC Medicaid providers will begin receiving reverification notices.
Effective with date of service Feb. 25, 2022, the Medicaid and NC Health Choice programs cover tebentafusp-tebn injection.
Effective with date of service Feb. 28, 2022, the Medicaid and NC Health Choice programs cover cabotegravir extended-release injectable suspension, for intramuscular use (Apretude).
Effective with date of service Feb. 23, 2022, the Medicaid and NC Health Choice programs cover sirolimus protein-bound particles for injectable suspension (albumin-bound).
Effective with date of service March 29, 2022, the Medicaid and NC Health Choice programs cover hepatitis b vaccine (recombinant) injectable suspension.
Effective with date of service March 2, 2022, the Medicaid and NC Health Choice programs cover plasminogen, human-tvmh lyophilized powder for reconstitution.
EVV for Home Health in January 2023
Effective with date of service March 15, 2022, the Medicaid and NC Health Choice programs cover naloxone hydrochloride injection for intramuscular or subcutaneous use.