Effective Jan. 1, 2026, NC Medicaid has amended Clinical Coverage Policy 1T-2.
Topics Related to All Providers
Promulgation of New Clinical Coverage Policies and Amendment to Clinical Coverage Policy 8A Enhanced Mental Health and Substance Abuse Services.
Effective Jan. 1, 2026, The Acute Inpatient Hospital Services policy has been revised.
Effective with date of service Jan. 1, 2026, new Current Procedure Terminology (CPT) codes have been added or deleted, and descriptions of some existing codes have been updated.
Coverage for Healthcare Common Procedure Coding System Code G0512 is end-dating effective Dec. 31, 2025.
Effective for dates of service on or after Feb. 1, 2026, claims for certain drug testing procedure codes must include an individual ordering provider NPI.
Clinical Coverage Policy 1S-11 will include coverage for AlloMap® effective Jan. 1, 2026.
The 2026 initial training dates for Community Alternatives Program consumer direction are now available.
This bulletin applies to NC Medicaid Direct and NC Medicaid Managed Care.
NC Medicaid is advising of a phased-in process for the reinstatement of non-emergency medical transportation rates to those in effect Sept. 30, 2025.