Blog Entry List

Standard Plans temporarily extended minimum appeal timeframes to support the transition to NC Medicaid Managed Care.
The Food and Drug Administration and the Advisory Committee on Immunization Practices have authorized COVID-19 boosters for all adults (18 years and older).
The Pre-Admission Screening and Resident Review application has changed its website domain address.
NC Medicaid has extended its deadline to February 2022 to send the renewed waiver application to the Centers for Medicare and Medicaid Services to request approval of the CAP/C waiver for another five years.
The December 2021 NC Medicaid Personal Care Services Public Health Emergency Uniform rates previously released in Special Bulletin COVID-19 #194 are being revised effective Dec. 1, 2021.
A provider enrollment fee must be collected from Medicaid and NC Health Choice providers initially enrolling in, or revalidating their enrollment in, Medicare, Medicaid or NC Health Choice, or adding a new Medicare practice location.
The National Committee for Quality Assurance (NCQA) has developed a Kidney Health Toolkit to assist in bringing awareness to diabetes.
Billing guidelines for PADP when billed with HCPCS code J3490.
Effective with date of service Sept. 22, 2021, the Medicaid and NC Health Choice programs cover tisotumab vedotin-tftv for use in the PADP when billed with HCPCS code J9999.
Effective with date of service Aug. 23, 2021, the Medicaid and NC Health Choice programs cover pneumococcal 20-valent conjugate vaccine for use in the PADP when billed with HCPCS code 90677.
NC Medicaid is extending all current COVID-19 temporary provider rate increases through Dec. 31, 2021.
The NC Medicaid Behavioral Health and Intellectual/Developmental Disabilities (I/DD) Tailored Plans will now launch on Dec. 1, 2022. The original launch date had been planned for July 1, 2022.
Effective with date of service Jan. 1, 2022 (updated from Sept. 29, 2021), the Medicaid and NC Health Choice programs cover Pfizer-BioNTech COVID-19 Vaccine (12 years of age and older).
Pfizer Pediatric COVID-19 vaccine is authorized for use under an Emergency Use Authorization for active immunization to prevent COVID-19.
Effective Nov. 1, 2021, involuntary disenrollments from the Program of All-inclusive Care for the Elderly will no longer be suspended for any reason.