Clinical Coverage Policy 1A-22, Medically Necessary Circumcision, has been revised and will post with an effective date of Jan. 1, 2021 on the NC Medicaid website.
Blog Entry List
An amended version of Clinical Coverage Policy 1E-7, Family Planning Services with an effective date of Dec. 1, 2020, was posted to the NC Medicaid Clinical Coverage Policy webpage.
Effective Oct. 1, 2020, NC Medicaid will now cover services for transversus abdominis plane blocks for Medicaid and NC Health Choice beneficiaries 11 years and older.
Program of All-inclusive Care for the Elderly (PACE) organizations should continue to follow the guidance of local, state and federal officials regarding COVID-19 and thoroughly document reasoning for making decisions which may fall outside of the PACE program model.
This bulletin revises the COVID-Response Site criteria established in SPECIAL BULLETIN COVID-19 #82.
EVV Training for providers using NC Medicaid’s EVV solution, Sandata, is now underway with instructor-led training webinars filling up fast. Training is required to ensure all agency employees are ready to capture EVV visit data.
Clarification regarding Electronic Visit Verification (EVV) and how it applies to in-home caregivers, including service codes for EVV and frequently asked questions on this topic.
NC Medicaid will host a Stakeholder Engagement meeting regarding Electronic Visit Verification on Thursday, Dec. 17, 2020, at 10 a.m. Registration is required.
Updates on the consent form expiration date and clarifications related to the Aug. 15, 2020 policy update.
Claim Denials for Sterilization CPT Code 58661
As Medicaid and NC Health Choice transition to managed care, beneficiaries will be notified to select a Prepaid Health Plan as well as a Primary Care Provider/Advanced Medical Home. Beneficiaries who do not self-select will be auto assigned by the Department.
Effective July 26, 2020, Registered Dieticians and Nutritionists may enroll in Medicaid or the NC Health Choice program to provide and bill for this service for pregnant women and beneficiaries less than 21 years of age.
Effective with date of service Jan. 1, 2020, the Medicaid and NC Health Choice programs cover famotidine injection (Pepcid®) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3490 - Unclassified drugs.
Effective with date of service Aug. 4, 2020, the Medicaid and NC Health Choice programs cover amisulpride injection, for intravenous use (Barhemsys®) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3490 - Unclassified drugs.
Effective with date of service Nov. 13, 2020, the Medicaid and NC Health Choice programs cover meningococcal [Groups A, C, Y, W] conjugate vaccine, solution for intramuscular injection (MenQuadfi™) for use in the Physician Administered Drug Program.