Blog Entry List

For facilities using a point-of-care antigen test device for detection of SARS-CoV-2, this is a reminder that providers are required by State Health Director Order to report all results, positive and negative, of diagnostic testing for SARS-CoV-2, the virus that causes COVID-19. 
Following the Oct. 30, 2020, announcement that the NCTracks secure portal is live, providers are encouraged to submit qualifying COVID-19 related primary care services claims for reimbursement through the NCTracks secure portal.  
DHHS has announced the launch of NC Medicaid’s managed care enrollment website, www.ncmedicaidplans.gov, in preparation for the launch of Medicaid Managed Care scheduled on July 1, 2021. Medicaid Managed Care open enrollment will begin March 15, 2021 and will continue through May 14, 2021.
The Advanced Medical Home Tier Attestation Tool, available on the NCTracks Secure Provider Portal Status and Management page has been modified. Providers may use this tool to downgrade from an AMH Tier 3 level provider to an AMH Tier 2 level provider.
Updates include NC-MIPS is Open for Program Year 2020; Program Year 2020 Webinar Series; The Security Risk Analysis and Program Year 2021 Announcements. 
The portal for providers to request reimbursement for COVID-19 related primary care services for uninsured individuals is live and can be accessed through the NCTracks secure portal.
The following new or amended clinical coverage policies are available on the Clinical Coverage Policies web page on NC Medicaid’s website.
Effective with the date of service Oct. 1, 2020, CMS has added new HCPCS codes (J codes), deleted others and changed the description of some existing codes. 
Attention Advanced Medical Homes, Carolina Access and CCNC Primary Care Practices
Consistent with the federal Department of Health and Human Services’ extension of the federal COVID-19 Public Health Emergency to January 21, 2021, NC Medicaid is extending COVID-19 temporary provider rate increases and clinical coverage policies to that same date. 
All temporary Durable Medical Equipment (DME) policy flexibilities outlined in COVID-19 Special Bulletins remain in effect. An amended version of Clinical Coverage Policy 5A-3, Nursing Equipment and Supplies with an effective date of Oct. 1, 2020, was posted to the NC Medicaid Clinical Coverage Policy web page. 
All temporary Durable Medical Equipment (DME) policy flexibilities outlined in COVID-19 Special Bulletins remain in effect. An amended version of Clinical Coverage Policy 5A-2, Respiratory Equipment and Supplies with an effective date of Oct. 1, 2020, was posted to the NC Medicaid Clinical Coverage Policy web page.  
Effective with date of service Aug. 20, 2020, the Medicaid and NC Health Choice programs cover viltolarsen injection, for intravenous use (Viltepso™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3490 - Unclassified drugs.
Effective with date of service Sept. 11, 2020, the Medicaid and NC Health Choice programs cover infliximab-axxq for injection, for intravenous use (Avsola) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code Q5121 - Injection, infliximab-axxq, biosimilar, (avsola), 10 mg.
Effective with date of service Aug. 6, 2020, the Medicaid and NC Health Choice programs cover belantamab mafodotin-blmf for injection, for intravenous use (Blenrep™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.