Topics Related to All Providers

To continue supporting providers interested in obtaining certification as an Advanced Medical Home Plus (AMH+) practice or Care Management Agency (CMA), the Round 1 application deadline is being extended from March 1, 2021 to June 1, 2021.

NC Medicaid is initiating its final phase of reconciling projected versus actual testing cost submission activity for nursing home staff testing payments authorized under Secretarial Orders 2 and 4 on March 1, 2021. 

Effective June 1, 2020, NC Medicaid began reimbursing COVID-19 testing for “Be Smart” Family Planning (MAFDN) beneficiaries through the NC Medicaid Optional COVID-19 Testing (MCV) Program. NC Medicaid is adding codes into NC Tracks for lab testing coverage for MAFDN beneficiaries with retroactive effective dates. 

This bulletin informs LME-MCOs and providers about the amendments made to providers types eligible to bill the Screening, Brief Intervention and Referral to Treatment (SBIRT) CPT codes effective as of March 1, 2021.

The latest information providers need to know about the transition to Medicaid Managed Care. Update includes the Provider Directory and Health Plan Look-Up Tool, contracting reminders, Provider Playbook updates, upcoming webinars and more.

The Centers for Medicare & Medicaid Services and the American Medical Association have announced the release of several new codes to report testing for COVID-19. 

Additional criteria has been added to identify beneficiaries as eligible for Behavioral Health I/DD Tailored Plans. 

The U.S. Food and Drug Administration has issued an Emergency Use Authorization to permit the emergency use of the unapproved monoclonal antibodies to be administered for the treatment of mild to moderate COVID-19 in some patients. 

Effective Jan. 1, 2021, NC Medicaid and NC Health Choice are temporarily covering Healthy Opportunities screening to encourage providers to gain capacity for screening Medicaid beneficiaries for unmet health-related resource needs and referring them to appropriate community-based resources prior to the launch of Medicaid managed care.  

Effective April 1, 2021, as part of the transition to Medicaid Managed Care, NC Medicaid will offer time-limited payment  to practices that have attested into Advanced Medical Home Tier 3 if they can demonstrate successful readiness for AMH Tier 3 responsibilities.