Topics Related to All Providers
The N.C. Medicaid and N.C. Health Choice (NCHC) application fee is $100, which covers costs associated with processing enrollment applications. The $100 application fee is required for both in-state and border-area (within 40 miles) providers during initial enrollment and when providers complete the five-year reverification process.
The Centers for Medicare & Medicaid Services announced an increase in the Affordable Care Act provider enrollment application fee.
Effective Oct. 29, 2017, NCTracks will implement a quarterly Maintain Eligibility Process which identifies providers with no claim activity within the past 12 months. The provider must attest electronically in NCTracks to remain active.
The American Medical Association (AMA) publishes an annual Current Procedural Terminology (CPT) manual each fall outlining new, revised, and deleted procedural codes effective January 1 of the following calendar year. (For complete information regarding all code and description changes, refer to the 2018 edition of Current Procedural Terminology.) N.C. Medicaid reviews these codes changes to determine clinical coverage for the Medicaid program.
Effective Feb. 1, 2018, N.C. Medicaid will cover balloon sinus ostial dilatation (BOD) surgery. The BOD policy will outline the new coverage for applicable CPT procedure codes.
Note: This article was previously published in the September 2017 Medicaid Bulletin. It is being republished with updates.
Note: This article was originally published in the October 2017 Medicaid Bulletin. This is the final Medicaid Bulletin publication.
‘High risk” individual providers and provider organizations, as outlined in NC General Statute 108C-3g, and individual owners with 5 percent or more direct or indirect ownership interest in a “high risk” organization are required to submit fingerprints to the N.C. Medicaid program.
‘High risk” individual providers and provider organizations, as outlined in NC General Statute 108C-3g, and individual owners with 5 percent or more direct or indirect ownership interest in a “high risk” organization are required to submit fingerprints to the N.C. Medicaid program.
Note: This article is being republished monthly. It was originally published in the December 2017 Medicaid Bulletin with revisions.