Topics Related to All Providers

NC Medicaid Private Duty Nursing Taxonomy Added to the NC Medicaid Home Health 3-A Fee Schedule - Updated

This bulletin replaces the previous bulletin published Nov. 21, 2022.

Advanced Medical Home Provider Manual 2.4.3 Released

Replaces the prior version issued in February 2022

NC Medicaid Managed Care Quality Strategy Updated

Please provide feedback by Jan. 6, 2023

NC Medicaid Begins Tailored Care Management Dec. 1, 2022

A multidisciplinary care team will provide whole-person care management that addresses all of a beneficiary’s needs

NC Medicaid Managed Care Provider Update – Nov. 29, 2022

Upcoming milestones, Provider Playbook updates, organizational Provider affiliation requirement, Beneficiary assignment file and more

Bevacizumab-maly Injection, for Intravenous Use (Alymsys®) HCPCS Code J9999: Billing Guidelines

Effective with date of service Oct. 5, 2022, Medicaid and NC Health Choice cover Bevacizumab-maly injection (Alymsys)

Duplicate Billing of Long-Acting Reversible Contraceptive Claims, From Point-of-Sale Pharmacy Claims and Duplicated on Professional Claims

This error occurred when the LARC was filled by a point-of-sale pharmacy and inserted by the provider in the clinic.

NC Medicaid Private Duty Nursing Taxonomy Added to the NC Medicaid Home Health 3-A Fee Schedule

Taxonomy numbers are not included in Clinical Policy but are included in the associated Fee Schedules.

Updated Coverage for Psychiatric Collaborative Care Management Effective Dec. 1, 2022

Includes HCPCS Code G0512 for RHCs and FQHCs

Feedback Requested: NC Medicaid Care Delivery and Value-Based Payment Design

We encourage stakeholders to provide feedback by Dec. 19, 2022.