NC Medicaid is committed to ensuring our beneficiaries continue to receive Medicaid and NC Health Choice services with no interruptions or delays due to the novel coronavirus (COVID-19) outbreak. A webcast has been scheduled to discuss temporary modifications to certain policies and provide related billing codes.
Blog Entry List
Effective March 1, 2020, Medicaid will begin issuing letters to PDN agencies addressing non-compliance with the timely submission of required documentation as indicated in the Request for Additional Information notice.
Effective with date of service Jan. 6, 2020, Medicaid and NC Health Choice programs cover fam-trastuzumab deruxtecan-nxki for injection, for intravenous use (Enhertu) for use in the Physician Administered Drug Program when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.
Effective with date of service Dec. 31, 2019, the Medicaid and NC Health Choice programs cover enfortumab vedotin-ejfv for injection, for intravenous use (Padcev) for use in the Physician Administered Drug Program when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.
The department is releasing a Behavioral Health Crisis System Memo for Standard Plans
While the implementation of managed care has been suspended as legislative action is needed to move forward, the Department of Health and Human Services continues to work on the design of Standard Plans and Behavioral Health and Intellectual Developmental Disability (I/DD) Tailored Plans. The Department is releasing a Behavioral Health Crisis System Memo for Standard Plans.
NC-MIPS is Open for Program Year 2019; The Security Risk Analysis (SRA); Reminder from CMS Regarding Objective 6 and Objective 7; Clarification from CMS Regarding Objective 5 Measure 1: Patient Electronic Access and General Reminders.
Effective with date of service Jan. 1, 2020, the Centers for Medicare & Medicaid Services (CMS) has identified some new CPT and HCPCS codes for reimbursement in ambulatory surgery.
The North Carolina State Health Director’s Standing Order for Naloxone authorizes any pharmacist practicing in the state of North Carolina and licensed by the North Carolina Board of Pharmacy to dispense naloxone to any person who meets the set criteria.
NC Medicaid has provided instructions to NCTracks on updating the claims processing system. The following procedure code list has been updated recently to include additional NP and PA taxonomies.
The Department has decided to further extend the initial application deadline for providers from Feb. 21, 2020 to June 2020 (date TBD).
The Department has extended the public comment period for the Behavioral Health I/DD Tailored Plan Request for Applications Pre-Release Policy Paper published on Jan. 30, 2020.
On Monday, Feb. 10, 2020, the Department will host a webinar to discuss the Behavioral Health I/DD Tailored Plan Request for Applications (RFA) Pre-Release Policy Paper published on Jan. 30, 2020.
Today the Department of Health and Human Services issued the NC DHHS Transition of Care Draft Policy for public comments detailing the requirements under which the Standard Plan Prepaid Health Plans (PHPs) will facilitate transition of care for members transitioning between PHPs or service delivery systems.
The following new or amended clinical coverage policies are available on the Clinical Coverage Policies web page on NC Medicaid’s website.