This bulletin provides guidance to providers caring for NC Medicaid beneficiaries also enrolled in Marketplace coverage through HealthCare.gov.
Topics Related to All Providers
Effective Aug. 1, 2024, Medicaid will require a primary diagnosis of spinal subluxation for NC Medicaid Direct claims.
Effective Aug. 1, 2024, NC Medicaid will cover obesity management medications for beneficiaries 12 years of age and older.
Effective Aug. 1, 2024, over the counter oral contraceptive Opill will be available without a prescription, at no cost.
Effective June 1, 2024, CPT codes are newly eligible for coverage.
Impacts NC Medicaid Managed Care Standard Plans, Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans and LME/MCOs.
Providers should work with the Tailored Plans and Tailored Care Managers to support Medicaid beneficiaries transitioning to 1915(i) services.
AMH Provider Manual May 2024 reflects all program modifications and changes that impact provider contracts and operations.
This bulletin applies to NC Medicaid Managed Care Standard Plans.
Effective retroactive to April 1, 2023, Z31.430 and Z31.440 will be covered diagnosis codes in NCTracks.