In consideration of the evolving needs for PCS providers, in place of the outbreak rates, NC Medicaid will provide all PCS providers, including CAP/C and CAP/DA, a single, uniform, temporary rate increase that will enable them all to better address the various increased costs associated with staffing during the COVID-19 PHE.
Blog Entry List
UPDATE Oct. 28, 2021: Procedure code T1004 has been removed from this list, as it is excluded, and was originally listed in error. EVV visits for respite services must follow EVV capture requirements.
The latest transition dates for county realignments.
This form is for members who wish to change their primary care assignment throughout the year.
The federal government has now extended the public health emergency (PHE) through Jan. 16, 2022.
Effective Nov. 01, 2021, all encounters subject to EVV will require an EVV visit history.
Effective Oct. 18, 2021, providers experiencing EVV user error claim denials will not be granted hardship advance.
Effective with date of service Aug. 27, 2021, NC Medicaid covers selexipag for injection.
Effective with date of service Aug. 10, 2021, NC Medicaid covers avalglucosidase alfa-ngpt for injection.
Clinical Coverage Policy 1E-6, Transitioned to Pregnancy Management Program Effective July 1, 2021.
Medicaid has become aware that some providers have rendered this service without obtaining prior approval.
Effective Oct. 22, 2021, NC Medicaid-enrolled providers can bill code 99401 with HM modifier for telephone outreach to unvaccinated Medicaid beneficiaries.
Individual Provider Affiliation required for certain providers by Nov. 21, 2021. Keeping NCTracks records current can help claims processing.
Cost sharing, such as deductibles, coinsurance, or copayments are waived for any Medicaid service.
In response to the COVID-19 public health emergency, the Centers for Medicare and Medicaid Services (CMS) is implementing 12 new procedure codes to describe the introduction or infusion of therapeutics into the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS), effective Aug. 1, 2020.