Blog Entry List
NC-MIPS is Open for Program Year 2019 through April 30, 2020, The Security Risk Analysis, Reminder from CMS Regarding Objective 6 and Objective 7, Clarification from CMS Regarding Objective 5 Measure 1: Patient Electronic Access and General Reminders
SPECIAL BULLETIN COVID-19 #34 replaces the following Medicaid Bulletins in their entirety: SPECIAL BULLETIN COVID-19 #9: Telehealth Provisions – Clinical Policy Modification; SPECIAL BULLETIN COVID-19 #19: Telehealth Provisions – Clinical Policy Modification and SPECIAL BULLETIN COVID-19 #28: [ADDENDUM to Bulletin #9 Effective March 20, 2020] : Telehealth Provisions – Clinical Policy Modification. New telehealth codes, F. Place of Service change and a clarification to "psychologists" are included.
SPECIAL BULLETIN COVID-19 #35 replaces in its entirety SPECIAL BULLETIN #20 – Enhanced Behavioral Services.
SPECIAL BULLETIN COVID-19 #36 replaces in its entirety SPECIAL BULLETIN COVID-19 #21: Telehealth Provisions - Outpatient Specialized Therapies and Dental Services. Changes are to F. Place of Service for Outpatient Specialized Therapy and for Dental Services, and includes new teledentistry codes and guidance.
NC Medicaid has implemented flexibilities on how Medicaid providers and beneficiaries receive Medicaid services in the wake of COVID-19. Utilization and prior approval limits for specific State Plan Medicaid services will be relaxed for all Medicaid beneficiaries impacted by COVID-19 including individuals participating in the NC Innovations Waiver and the NC TBI Waiver. Medicaid is hosting two webinars to further discuss the flexibilities.
*This Bulletin has been updated in SPECIAL BULLETIN COVID-19 #175: Updated Guidance for Non-Emergency Medical Transportation - Aug. 19, 2021
“NC Medicaid COVID-19 Updated Guidelines for Non-emergency Medical Transportation (NEMT)” provides information to local Departments of Social Services (DSS) and NEMT providers on personal protective equipment (PPE).
Effective March 10, 2020, the Division of Health Benefits (DHB) implemented a 5% rate increase for certain Medicaid provider groups listed in the Bulletin. DHB will systematically reprocess claims submitted with dates of service beginning March 10, 2020, through the implementation date of the rate increase.
Updated April 22, 2020: Link to downloadable list of enrollmed DMEPOS providers added. Effective March 30, 2020 NC Medicaid and NC HealthChoice coverage was added for HCPCS code A4670 – automatic blood pressure monitor.
On March 10, 2020, Governor Roy Cooper issued an executive order declaring a State of Emergency for North Carolina to respond to COVID-19. In addition, the Department of Health and Human Services made several recommendations to slow the spread of COVID-19 and reduce the number of people infected.
Effective March 30, 2020 NC Medicaid is temporarily modifying the Home Infusion Therapy Clinical Coverage Policy No.: 3H-1 to better enable the delivery of remote care to Medicaid members. These temporary changes will end the earlier of the cancellation of the North Carolina state of emergency declaration or when this policy is rescinded. This expansion of home infusion therapy serves to allow beneficiaries to receive services in the home rather than in a dedication infusion center to reduce potential exposure to COVID-19.
PACE organizations are responsible for providing all required Medicare and Medicaid covered services to its PACE participants. This responsibility also extends to the participants’ home setting. Due to the COVID-19 pandemic, NC Medicaid recognizes that PACE organizations will need to adjust business operations and the methods utilized to address the needs of PACE participants.
NOTE: SPECIAL BULLETIN COVID-19 #28 has been replaced in its entirety by SPECIAL BULLETIN COVID-19 #34: Telehealth Clinical Policy Modifications - Definitions, Eligible Providers, Services and Codes.
NOTE: SPECIAL BULLETIN COVID-19 #19 has been replaced in its entirety by SPECIAL BULLETIN COVID-19 #34: Telehealth Clinical Policy Modifications - Definitions, Eligible Providers, Services and Codes.
NOTE: SPECIAL BULLETIN COVID-19 #20 has been replaced in its entirety by SPECIAL BULLETIN COVID-19 #35: Telehealth Clinical Policy Modifications - Enhanced Behavioral Services
NOTE: SPECIAL BULLETIN COVID-19 #21 has been replaced in its entirety by SPECIAL BULLETIN COVID-19 #36: Telehealth Clinical Policy Modifications - Outpatient Specialized Therapies and Dental Services