Topics Related to Behavioral Health Providers

NC Medicaid Managed Care Provider Update – October 3, 2024

Includes information on the Provider Ombudsman, NC Medicaid Webinars, Newly Effective Changes to Service Location Management, and more. 

Update on NC Medicaid Temporary Flexibilities Due to Hurricane Helene – October 1, 2024

This is an update to a bulletin published on Sept. 26, 2024, regarding flexibilities related to Hurricane Helene for NC Medicaid beneficiaries.

NC Medicaid Temporary Flexibilities Due to Hurricane Helene

Provider guidance for reimbursement, enrollment and providing care for Medicaid beneficiaries

NC Medicaid Behavioral Health I/DD Tailored Plans Federally Qualified Health Center /Rural Health Clinics PPS-APM wrap payment methodology

Reimbursement methodology changes revised to begin with dates of service on or after Dec. 1, 2024.

NC Medicaid Increasing Reimbursement Rates for the Substance Abuse Intensive Outpatient Program and Substance Abuse Comprehensive Outpatient Treatment

Rate Changes are Effective Aug. 1, 2024

1915(i) Updates for Providers

Updates for providers on 1915(b)(3) services ending, new 1915(i) assessment tool and 1915(i) reassessments.

Ensuring Continuity of Care Through Tailored Plan Launch

Reminders for NC Medicaid Providers related to transitions at Tailored Plan Launch.

1915(b)(3) Service Transition for TP Eligible Members

Providers should work with the Tailored Plans and Tailored Care Managers to support Medicaid beneficiaries transitioning to 1915(i) services.

Flexibilities to Ease Provider Administrative Burden at Tailored Plan Launch

Includes medical and pharmacy prior authorizations, out of network provider rates and rules, and primary care provider changes

Tailored Care Management Options for Transitions to Community Living Medicaid Members

Members may now select to receive Tailored Care Management from a provider with Transition to Community Living Distinction.